Preoperative ureteral stenting in women with deep posterior endometriosis and ureteral involvement: Is it useful?. Issue 1 (29th October 2021)

• Record Type: Journal Article
• Authors: Borghese, Giulia; Raimondo, Diego; Esposti, Eugenia Degli; Aru, Anna Chiara; Raffone, Antonio; Orsini, Benedetta; Ambrosio, Marco; Iodice, Raffaella; Lenzi, Jacopo; Del Forno, Simona; Casadio, Paolo; Seracchioli, Renato
• Is Part Of: International journal of gynaecology and obstetrics. Volume 158:Issue 1(2022)
• Page Start: 179
• Page End: 186
• Publication Date: 2021-10-29
• Subjects: deep infiltrating endometriosis -- minimally invasive gynecological surgery -- ureteral endometriosis -- ureteral stent; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.13959
• Languages: English
• ISSNs: 0020-7292

Abstract

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. Abstract : Preoperative ureteral stent placement in patients with large deep infiltrating endometriosis nodules and/or grade I–II hydronephrosis requiring surgery for endometriotic ureteral involvement does not reduce postoperative complications.