Can ureteral stent encrustation analysis predict urinary stone composition?

摘要

OBJECTIVES: To determine the value of mid-infrared spectroscopy (MIRS) of ureteral stent encrustations in predicting urinary stone composition. METHODS: A retrospective study analyzed the composition of stent encrustations and urinary stones by MIRS in patients who had had a stent for ureteral obstruction between 2001 and 2003. The overall correlation was evaluated. The correlation coefficient kappa for agreement between the proportions of each component was calculated. RESULTS: A total of 72 stents and 72 stones from 72 patients were analyzed. The mean stent indwelling time was 55.5 days (range 14 to 102). The stents had been placed for fever (52 cases, 72%), pain refractory to analgesics (15 cases, 21%), and impairment of kidney function (5 cases, 7%). The overall correlation between stone composition and stent encrustation was 71.4%, excluding biofilm analysis. The kappa value was 0.78 for the main component (n = 72; P < 0.0005), 0.61 for the secondary component (n = 72; P < 0.0005), and 0.91 for the agreement between the composition of encrustations at each end of a stent (n = 30; P < 0.0005). CONCLUSIONS: MIRS analysis of stent encrustations is a reliable method of predicting stone composition when the stone cannot be retrieved. Systematic MIRS analysis of stent encrustations is not recommended but can be very useful in clinical situations in which no stone is available.