A prospective study was performed radiologically to know the incidence and the degree of vesicourteral reflux in patients with double-J stent.
In this study, involved were 52 renal units of to 50 patients without vesicoureteral reflux before double-J stent insertion. Voiding cystourethrography was done a week and four weeks after the stent insertion. In patients with vesicoureteral
refiux
caused by the stent insertion, woiding cystourethrography was repeated 3 days after the stent removal to know the persistence of the reflux.
Vesicoureteral reflux occurred in 26 of 52 renal units (50%) one week after the stent insertion. The reflux was grade I/III in one renal unit (4%), grade II or III/III in 25 renal units (96%) according to grading system defined arbitrarily by us.
The
reflux persisted until 4 weeks after the stent insertion in 25 renal units except a renal unit. In 60 or more-vear-old male patients, 10 of 12 renal units (83%) showed the reflux, contrast to 5 of 14 renal tinits (36%) in the remained male
patients
(p=0.01). There was no difference in the incidence of the reflux by size of the stent, age, sex, and underlying disease. The reflux in stented state disappeared in all the patients after the stent removal.
From these we concluded as follows. Vesicoureteral reflux occurred in 50 percent of renal units in patients with double-J stent. and the grade of the reflux was high. In was more common in aged male patients, which suggested close relation
between
the
occurrence of the reflux and the intravesical pressure on voiding in stented patients. After the stent removal the reflux disappeared. Therefore long term indwelling of the stent seemed to have no harmful effect on antireflux function of
vesicoureteral
unit.
|