To examine the safety and effectiveness of placing ureteral stents in an office-based setting versus in the operating room.

A retrospective chart review was performed to examine outcomes, specifically complication rate, unanticipated hospitalizations, and stent failures, when patients received JJ stents in the clinic procedure suite, using local analgesia and/or nitrous oxide gas analgesia, compared to patients who had ureteral stents placed in the OR, typically with general anesthesia. Additionally, multivariable analysis was performed to determine predictors of complications.

565 procedures were performed in the clinic, and 179 were performed in the OR. The complication rate for the clinic group was 4.1%, compared to 7.8% in the OR group. Unplanned admissions to the hospital occurred after 3.0% of clinic procedures and 9.5% of OR procedures. Stent placements failed in 1.1% of clinic procedures and 0.56% of OR procedures. Clinic procedure time was 10 minutes vs. 12 minutes in the OR (p=0.0097). Clinic vs. OR setting was not predictive of complications (p=0.2910). We did not identify factors that impacted complication rate in ureteral stent placement in the clinic vs. OR setting. Notably, the procedure time for a clinic stent placement was significantly shorter than the OR stent placement.

This study demonstrates excellent outcomes with a novel approach to a standard procedure, with shorter procedure time and no difference in complication rates.

Urology. 2019 Jul 13 [Epub ahead of print]

Karen M Doersch, Kim H Thai, G Luke Machen, Erin T Bird, Thomas P Reilly, Marawan M El Tayeb

Department of Urology, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY 14642, United States of America. Electronic address: ., Division of Urology, Department of Surgery, Baylor Scott and White Health, 2401 S. 31(st) St., Temple, TX 76502, United States of America.