EXPLORING EFFICACY OF INFANT FEEDING TUBE AS A LOW COST ALTERNATIVE TO STENTING IN LOWER URETERIC STONE MANAGEMENT

Authors

DOI:

https://doi.org/10.21272/eumj.2025;13(1):323-332

Keywords:

double J stent, endoscopic management, distal ureteral stones

Abstract

Introduction. Routine DJ stenting following URSL (Ureteroscopic Lithotripsy) is associated with irritative voiding symptoms, pain, UTI and requires additional hospital visit for stent removal. Externally draining ureteric catheters and stents with strings for easy self-removal have been used to overcome these drawbacks, but a cost effective and practical solution is yet to be found. Aim of this study is to evaluate the efficacy of placing an infant feeding tube (IFT) in lower ureter for 24 hours following URSL for lower ureteric stones in overcoming the stent related morbidity and avoiding a subsequent cystoscopy for stent removal.

Methods. A prospective randomised study was conducted wherein 110 patients undergoing URSL for lower ureteric stones were randomised into 2 equal groups such that routine DJ (Double J) stenting using a 5Fr 26 cm DJ stent was done in group 1 and a 5Fr infant feeding tube mounted on a 0.032 inch guidewire was placed in the lower ureter and drained externally in the remaining 55 patients.

Results. The average stone size in the DJ stent vs IFT group was 7.6 mm and 8.2 mm. Patients in the DJ stent group had a higher analgesic requirement (30% vs 23.6%). Irritative voiding symptoms 35 (63.6%) vs 4 (7.2%) [P=0.000]; hematuria 6 (10.9%) vs 1 (1.81%) [P=0.012] and fever 11 (20%) vs 4 (7.2%) [P=0.0047] were all significantly less in the IFT group.

Conclusions. Use of infant feeding tube to drain the lower ureter will significantly reduce irritative voiding symptoms, hematuria and fever associated with usage of DJ stents while avoiding the need for any secondary procedures like DJ stent removal.

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References

Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y. Epidemiology of stone disease across the world. World J. Urol. 2017;35:1301–1320. https://doi.org/10.1007/s00345-017-2008-6.

Almusafer M, Jawad Al‑Tawri AM. Complications of Ureteroscopic Stone Lithotripsy: A Multicentre Local Study. Hamdan Medical Journal 12(3):p 119-125, Jul–Sep 2019. https://doi.org/10.4103/HMJ.HMJ_73_18.

Bower PE, Pereira J, Al-Alao O, Kott O, Velez D, Thavaseelan S, Pareek G. Indications for stent omission after ureteroscopic lithotripsy defined: A single-institution experience with cost analysis. Arab J Urol. 2019 May 16;17(3):206-211. https://doi.org/10.1080/2090598X.2019.1614243.

Tang L, Gao X, Xu B, Hou J, Zhang Z, Xu C, Wang L, Sun Y. Placement of ureteral stent after uncomplicated ureteroscopy: do we really need it? Urology. 2011 Dec;78(6):1248-56. https://doi.org/10.1016/j.urology.2011.05.004. Epub 2011 Jul 18. PMID: 21762964.

Hiller SC, Daignault-Newton S, Rakic I, Linsell S, Conrado B, Jafri SM, et al. Appropriateness Criteria for Ureteral Stent Omission following Ureteroscopy for Urinary Stone Disease. Urology Practice, 9(3), 253–263. https://doi.org/10.1097/upj.0000000000000302

Boeykens, M., Keller, E. X., Bosio, A., Wiseman, O. J., Contreras, P., Ventimiglia, E., Talso, M., Pietropaolo, A., Tailly, T., & De Coninck, V. (2022). Impact of Ureteral Stent Material on Stent-related Symptoms: A Systematic Review of the Literature. European Urology Open Science, 45, 108–117. https://doi.org/10.1016/j.euros.2022.09.005

Bellos TC, Katsimperis SN, Kapsalos-Dedes SG, Tzelves LI, Kostakopoulos NA, Mitsogiannis IC, Varkarakis IM, Papatsoris AG and Deliveliotis CN. (2023), Ureteral Stent-Related Symptoms and Pharmacotherapy: A Brief Narrative Review. J Clin Pharm, 63: 1091-1100. https://doi.org/10.1002/jcph.2314.

Doersch KM, Elmekresh A, Machen GL, El Tayeb MM. The use of a string with a stent for self-removal following ureteroscopy: A safe practice to remain. Arab J Urol. 2018 Jun 27;16(4):435-440. https://doi.org/10.1016/j.aju.2018.04.005 PMID: 30534444; PMCID: PMC6277270.

Almusafer M, Jawad Al‑Tawri AM. Complications of Ureteroscopic Stone Lithotripsy: A Multicentre Local Study. Hamdan Medical Journal 12(3):p 119-125, Jul–Sep 2019. https://doi.org/10.4103/HMJ.HMJ_73_18.

Byrne RR., Auge BK, Kourambas J, Munver R, Delvecchio F, Preminger GM. (2002). Routine Ureteral Stenting is Not Necessary After Ureteroscopy and Ureteropyeloscopy: A Randomized Trial. Journal of Endourology, 16(1), 9–13. https://doi.org/10.1089/089277902753483646

Pérez-Fentes D, Aranda-Pérez J, de la Cruz JE, Soria F. (2022). Indications, Complications and Side Effects of Ureteral Stents. In: Soria, F., Rako, D., de Graaf, P. (eds) Urinary Stents. Springer, Cham. https://doi.org/10.1007/978-3-031-04484-7_2.

Khan AA, Khan SM, Kanth AN, Khan AM, Wani OA. Comparison of stented versus non-stented patients of ureteric calculi after intracorporeal lithotripsy. International Surgery Journal, 9(2), 426. https://doi.org/10.18203/2349-2902.isj20220336.

Al Demour, S., Alrabadi, A., AlSharif, A., Ababneh, M., Al-Taher, R., Melhem, M., et al. (2020). Ureteric stenting vs not stenting following uncomplicated ureteroscopic lithotripsy: A prospective randomised trial. Arab Journal of Urology, 18(3), 169–175. https://doi.org/10.1080/2090598X.2020.1762280

Prasad D, Satani Y, Singh S & Gajera D. (2021). A prospective comparative study of ureterorenoscopy with and without DJ stenting for the management of ureteric stones. International Surgery Journal, 8(12), 3606. https://doi.org/10.18203/2349-2902.isj20214753

El Harrech Y, Abakka N, El Anzaoui J, Ghoundale O, Touiti D. Ureteral stenting after uncomplicated ureteroscopy for distal ureteral stones: a randomized, controlled trial. Minim Invasive Surg. 2014;2014:892890. https://doi.org/10.1155/2014/892890. Epub 2014 Nov 9. PMID: 25431663; PMCID: PMC4241699.

Reddy SJ, Reddy BS, Chawla A, de la Rosette JJMCH, Laguna P, Hegde P, Shah A, Choudhary A, Kankaria S, Hiremath VK. Outcomes and Complications from a Randomized Controlled Study Comparing Conventional Stent Placement Versus No Stent Placement after Ureteroscopy for Distal Ureteric Calculus < 1 cm. Journal of Clinical Medicine. 2022; 11(23):7023. https://doi.org/10.3390/jcm11237023

Wahab AU, Alam N, Hussain A, Ali I, Khan I & Mirza ZI. (2023). Analysis of Stenting versus Non-Stenting in patients Undergoing Ureteroscopic Lithotripsy for Management of Ureteric Calculi. 17(7), 18–20. https://doi.org/10.53350/pjmhs202317718

Liu J, Cundy TP, Parker N, Lloyd M, Cho J, Catterwell RL. Implementing routine use of self-removed ureteric stents on extraction strings: prospective patient-reported outcome measures and complications. World J Urol. 2023 Dec;41(12):3759-3764. https://doi.org/10.1007/s00345-023-04653-z.

Liu H, Pan W, Zhang N. Ureteral stent removal using an extraction string after uncomplicated ureteroscopy: a cost-benefit analysis. Urol J. 2018 Nov 17;15(6):329-32.

Ozyuvali E, Resorlu B, Oguz U, Yildiz Y, Sahin T, Senocak C, Bozkurt OF, Damar E, Yildirim M, Unsal A. Is routine ureteral stenting really necessary after retrograde intrarenal surgery? Arch Ital Urol Androl. 2015 Mar 31;87(1):72-5. https://doi.org/10.4081/aiua.2015.1.72

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Published

2025-03-29

How to Cite

Patil, B. S. ., Patil, S. B. ., Patil, S. R. ., Kundargi, V. S. ., & Vaidya, M. K. . (2025). EXPLORING EFFICACY OF INFANT FEEDING TUBE AS A LOW COST ALTERNATIVE TO STENTING IN LOWER URETERIC STONE MANAGEMENT. Eastern Ukrainian Medical Journal, 13(1), 323–332. https://doi.org/10.21272/eumj.2025;13(1):323-332

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Section

EXPERT OPINION. GENERAL SURGERY