Double-J catheter management after ureteroscopy: symptoms and complications

Abstract

Background: Currently, a double-J catheter is placed in 70% of patients that undergo ureteroscopy because it is believed to decrease obstruction secondary to ureteral edema or stone fragments. However, catheter placement is not innocuous, given that it can result in a variety of side effects, such as urinary frequency, urgency, hematuria, dysuria, and tenesmus, as well as increase costs. The aim of the present study was to evaluate current double-J catheter management in patients after ureteroscopy and the associated postoperative symptoms.

Materials and methods: A retrospective study analyzing ureteroscopies performed at the Hospital Dr Manuel Gea Gonzalez throughout 2017 on patients above 18 years of age was conducted. Urology service re-admission frequency during the first postoperative week, the symptoms associated with double-J catheter use, and postoperative complications were evaluated.

Results: A total of 105 ureteroscopies were registered. Male sex was predominant (55%) and semirigid ureteroscopies were the most prevalent procedures (71%). A double-J catheter was preoperatively placed in 69 patients and postoperatively placed in 41 patients. During follow-up, the patients with double-J catheter placement presented with associated symptoms warranting an emergency room visit. Pollakiuria was the only significant association found (p=0.001). Ninety-five patients were stone-free, 61 (64.2%) of whom had double-J catheter placement. Two patients with no catheter presented with residual stones.

Conclusions: Of the 61 patients with double-J catheter, 57 (82%) presented with at least one symptom related to catheter placement. A total of 64.2% patients with a double-J catheter had uncomplicated ureteroscopy. Therefore, we believe it is necessary to conduct a randomized, prospective study with a larger number of patients to confirm the previously reported results and more clearly and objectively establish the indications for double-J catheter use at our hospital.