RESUMO
Ureteral stents are widely used in urological care, but they are often associated with adverse stent-related symptoms (SRS), such as painful urination, elevated urinary frequency, and abdominal discomfort. Antireflux ureteral stents have been developed to reduce stent-related pain and reflux by minimizing vesicoureteral reflux (VUR). This systematic review and meta-analysis of randomized controlled trials (RCTs) was undertaken to assess the efficacy of antireflux ureteral stents in mitigating SRS compared to conventional urethral stents. Our study included a total of 269 cases from three RCTs. The meta-analysis showed that antireflux ureteral stents were significantly more effective than standard stents in reducing SRS, including stent-related pain (odds ratio (OR): 4.80, 95% CI: 2.77, 8.31, p <0.00001), severe stent-related pain (OR: 8.35, 95% CI: 2.12, 32.89, p=0.002), flank pain while urinating (OR: 5.98, 95% CI: 3.35, 10.68, p <0.00001), and severe flank pain while urinating (OR: 15.79, 95% CI: 2.91, 85.57, p=0.001). There was no significant difference in the rates of postoperative creatinine abnormality or postoperative hydronephrosis between the two groups. Therefore, antireflux ureteral stents are more effective than standard stents in reducing SRS. This suggests that antireflux ureteral stents should be considered for patients undergoing ureteral stenting.
RESUMO
Matrix stones are a rare form of kidney stones, which are composed of mucoproteinaceous material. They are often difficult to diagnose as they are characteristically radiolucent on CT urinary tract. This difficulty is compounded in transplanted kidneys as obstructing stones commonly present without pain and can cause acute kidney injury. Here, we present a case of a 61-year-old female with a live-donor kidney transplant, who was found to develop deranged renal function on routine follow-up investigations. Therefore, a CT urogram was performed and it showed filling defects in the renal pelvis and upper ureter of the transplanted kidney. Therefore, diagnostic ureterorenoscopy was performed and three stones of about 7-8 mm each were found in the renal pelvis, they were treated by Holmium:Yttrium aluminium garnet (YAG) laser fragmentation. This case report describes the challenges in the management of this rare stone in a transplanted kidney.
