Foley catheter after ureteroscopy and JJ stent placement: a randomised prospective European Association of Urology Section of Urolithiasis-Young Academic Urologists (EULIS-YAU) endourology study

Tarik Emre Sener; Gunal Ozgur; Mehmet Cetin; Amelia Pietropaolo; Lazaros Tzelves; Francesco Esperto; Bhaskar Somani; Yiloren Tanidir

doi:10.1111/bju.16504

Foley catheter after ureteroscopy and JJ stent placement: a randomised prospective European Association of Urology Section of Urolithiasis-Young Academic Urologists (EULIS-YAU) endourology study

BJU Int. 2024 Aug 11. doi: 10.1111/bju.16504. Online ahead of print.

Authors

Tarik Emre Sener¹, Gunal Ozgur¹, Mehmet Cetin¹, Amelia Pietropaolo², Lazaros Tzelves³, Francesco Esperto⁴, Bhaskar Somani², Yiloren Tanidir¹

Affiliations

¹ Department of Urology, Marmara University Hospital, Istanbul, Turkey.
² Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
³ Department of Urology, University College of London Hospital, London, UK.
⁴ Department of Urology, Campus Bio-Medico University, Rome, Italy.

PMID: 39129326
DOI: 10.1111/bju.16504

Abstract

Objectives: To evaluate the effects of inserting a Foley catheter after ureteroscopy (URS) and JJ stent placement on pain scores, voiding patterns, biochemical parameters and postoperative complications.

Patients and methods: A randomised clinical trial (1:1) with adult patients following unilateral URS + JJ stent placement was planned. In Group A, no Foley catheter was placed, in Group B, a Foley catheter was placed following URS + JJ stent placement. The primary objective was to evaluate effect of placing a Foley catheter on International Prostate Symptom Score (IPSS), Ureteric Stent Symptom Questionnaire (USSQ) score and postoperative biochemical parameters. The secondary objective was to evaluate postoperative complications.

Results: A total of 112 patients were included (56/group). A ureteric access sheath was used in each patient. Patients had similar demographic and surgical parameters. The pre- and postoperative biochemical analyses including white blood cell count, C-reactive protein, procalcitonin and creatinine levels were similar between the two groups. The IPSS were similar between the two groups. All the subdomains of the USSQ were similar between two groups except Total Body Pain score, which was lower in Group B. The visual analogue scale scores were similar. Complications were all Clavien-Dindo Grade I and II, and the complication rate was 5.4% and 8.9% in Group A and B, respectively.

Conclusion: Placing a Foley catheter following URS + JJ stent placement did not show significant effects on postoperative biochemical parameters and voiding symptoms. However, a Foley catheter lowered the Total Body Pain score on the USSQ without having significant effects on VAS scores. The practice of placing a Foley catheter following URS and JJ stent placement should be based on surgeon's preference keeping in mind the potential positive effect on pain scores.

Keywords: catheterisation; infection; pain; stent; ureteroscopy.