An Exploration of Factors That Cause the Spontaneous Migration of Double-J Stents After Retrograde Intrarenal Surgery

Abstract

Objective: Retrograde intrarenal surgery (RIRS) is a minimally invasive and relatively new method of treatment for kidney stones. We aimed to identify the factors that cause stent migration in patients who have undergone RIRS to treat kidney stones. Materials and Methods: Four hundred and twenty-eight patients who underwent RIRS to treat kidney stones that were less than 2 cm in size and had JJ stents inserted intraoperatively between December 2013 and December 2017 were included in this study. For each patient, demographic data and, if present, JJ stent migration direction and postoperative complications were recorded. Twenty-eight patients who experienced JJ stent migration (group 1) and 400 patients who did not experience the migration (group 2) were compared. Results: Postoperative complications developed in a total of 39 (9.1%) patients. Seventeen complications were evaluated as minor (Clavien 1-2) and 22 (5.1%) were evaluated as major. Almost all of the major complications (n=21) were found to be associated with JJ stent migration. Urosepsis was detected in only one patient (Clavien 4). The mean ages in groups 1 and 2 were 45.4 +/- 17.3 years and 44.3 +/- 15.1 years, respectively. The mean stone size in group 1 was 16.9 +/- 3.0 mm, whereas it was 14.2 +/- 5.3 mm in group 2 (p=0.031). A comparison of both the groups showed that the likelihood of an occurrence of JJ stent migration increased significantly with the degree of hydronephrosis (p<0.001). Conclusion: JJ stent migration after RIRS increases the rate of major complications. An association was detected between JJ stent migration and an increase in stone size and the degree of hydronephrosis.