Preoperative ureteral stenting in women with deep posterior endometriosis and ureteral involvement: Is it useful?

Giulia Borghese, Borghese G, Diego Raimondo, Esposti ED, Eugenia Degli Esposti, Anna Chiara Aru, Aru AC, Raffone A, Antonio Raffone, Benedetta Orsini, Ambrosio M, Marco Ambrosio, Raffaella Iodice, Iodice R, Jacopo Lenzi, Simona Del Forno, Paolo Casadio, Renato Seracchioli
International Journal of Gynecology & Obstetrics · 2021 · vol. 158(1) , pp. 179–186 · doi:10.1002/ijgo.13959 · PMID:34606100 · W3203980051
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Systematic preoperative ureteral stenting in women with deep posterior endometriosis and ureteral involvement did not reduce complications but increased urinary tract infections and hospital stays.

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Abstract

OBJECTIVE: Systematic placement of a ureteral stent before surgery for posterior deep infiltrating endometriosis (DIE) was previously recommended, but it could increase perioperative complications. We evaluate the role of preoperative ureteral stent in women requiring surgery for ureteral involvement (UI) with large posterior DIE nodules and/or grade I-II hydronephrosis. METHODS: Women undergoing minimally invasive surgery for DIE with UI having posterior nodules >3 cm and/or grade I-II hydronephrosis from 2014 to 2019 were retrospectively included. We progressively changed our strategy from a systematic pre-operative stent insertion (S-PS, up to 2016) to a non-systematic one (NS-PS, from 2016). RESULTS: Eighty-eight women in the S-PS group and 96 in the NS-PS were included. Low urinary tract infections (UTI) were higher in the S-PS group (13.6% vs 2.1%, P = 0.003). Hospital stay was longer in women with S-PS (9.8 ± 5.3 days vs 6.7 ± 2.5 days, P < 0.001). Logistic regression analysis confirmed a significant association between NS-PS and low UTI (adjusted OR 0.20, 95% CI 0.05-0.81, P = 0.024). CONCLUSION: Systematic placement of a ureteral stent before surgery in women requiring surgery does not reduce overall perioperative complication rate, but it is associated with a longer duration of hospitalization and a higher low UTI rate.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Hydronephrosis Hydronephrosis Hydronephrosis Hydronephrosis Ureteral Diseases Ureteral Diseases Ureteral Diseases Ureteral Diseases Female Female Humans Humans Retrospective Studies Retrospective Studies Stents Stents

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (33)

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