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dc.contributor.advisorUreteral Calculi
dc.contributor.authorNabi, G
dc.contributor.authorCook, Jonathan Alistairen
dc.contributor.authorN'Dow, James Michael Oluen
dc.contributor.authorMcClinton, S
dc.date.accessioned2007-04-12T11:01:50Z
dc.date.available2007-04-12T11:01:50Z
dc.date.issued2007-03-17
dc.identifier.citationNabi, G., Cook, J., N'Dow, J., McClinton, S. (2007) Outcomes of stenting after uncomplicated ureteroscopy: systematic review and meta-analysis. BMJ, 334en
dc.identifier.issn1468-5833
dc.identifier.otherPubMed: 17311851
dc.identifier.urihttp://hdl.handle.net/2164/135
dc.description.abstractObjective To investigate the potential beneficial and adverse effects of routine ureteric stent placement after ureteroscopy. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Cochrane controlled trials register (2006 issue 2), Embase, and Medline (1966 to 31 March 2006), without language restrictions. Review methods We included all randomised controlled trials that reported various outcomes with or without stenting after ureteroscopy. Two reviewers independently extracted data and assessed quality. Meta-analyses used both fixed and random effects models with dichotomous data reported as relative risk and continuous data as a weighted mean difference with 95% confidence intervals. Results Nine randomised controlled trials (reporting 831 participants) were identified. The incidence of lower urinary tract symptoms was significantly higher in participants who had a stent inserted (relative risk 2.25, 95% confidence interval 1.14 to 4.43, for dysuria; 2.00, 1.11 to 3.62, for frequency or urgency) after ureteroscopy. There was no significant difference in postoperative requirement for analgesia, urinary tract infections, stone free rate, and ureteric strictures in the two groups. Because of marked heterogeneity, formal pooling of data was not possible for some outcomes such as flank pain. A pooled analysis showed a reduced likelihood of unplanned medical visits or admission to hospital in the group with stents (0.53, 0.17 to 1.60), although this difference was not significant. None of the trials reported on health related quality of life. Cost reported in three randomised controlled trials favoured the group without stents. The overall quality of trials was poor and reporting of outcomes inconsistent. Conclusions Patients with stents after ureteroscopy have significantly higher morbidity in the form of irritative lower urinary symptoms with no influence on stone free rate, rate of urinary tract infection, requirement for analgesia, or long term ureteric stricture formation. Because of the marked heterogeneity and poor quality of reporting of the included trials, the place of stenting in the managementof patients after uncomplicated ureteroscopy remains unclear.en
dc.format.extent548221 bytes
dc.format.extent7 p.
dc.format.mimetypeapplication/pdf
dc.language.isoenen
dc.publisherBMJ Publishingen
dc.relation.ispartofBMJ (Clinical research ed.)
dc.subjectUreteroscopyen
dc.subjectStentsen
dc.subjectUrinary Catheterizationen
dc.subjectSystematic Reviewen
dc.subjectHematuria
dc.subjectHumans
dc.subjectLithotripsy
dc.subjectPain Measurement
dc.subjectPain, Postoperative
dc.subjectQuality of Life
dc.subjectRandomized Controlled Trials as Topic
dc.subjectStents
dc.subjectUreteral Obstruction
dc.subjectUreteroscopy
dc.subjectUrinary Catheterization
dc.subjectUrinary Retention
dc.subjectRC Internal medicine
dc.subject.lccRC
dc.titleOutcomes of stenting after uncomplicated ureteroscopy: systematic review and meta-analysis.en
dc.typeJournal Articleen
dc.typetext
dc.contributor.institutionUniversity of Aberdeen, School of Medicine & Dentistry, Division of Applied Health Sciences
dc.description.statusPeer reviewed
dc.description.versionPublisher PDF
dc.identifier.doihttp://dx.doi.org/10.1136/bmj.39119.595081.55


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