RADIOLOGICAL AND DEMOGRAPHICAL DETERMINANTS OF DOUBLE-J STENT INSERTION SUCCESS FOR OBSTRUCTING URETERIC CALCULI IN TERTIARY HEALTH CARE CENTRE OF NORTH INDIA

Abstract

Background: Urolithiasis is a common condition with a lifetime prevalence of 1–15%. Obstructing ureteric calculi accompanied by signs of urinary tract infection and fever represent  true urological emergency and warrants urgent upper-tract drainage, with definitive stone treatment deferred until the patient is stabilized and infection resolved. This drainage can be achieved either by inserting internal ureteral stent (DJ stent) or percutaneous nephrostomy tube. This study aimed at studying such demographic and radiological factors affecting the insertion of DJ stent in obstructed ureteric calculi, providing a distinct advantage for the practicing urologists to predict the probability of successful stent passage in such cases pre-operatively. Materials and Methods: This hospital-based prospective observational study was conducted in the Department of Surgery at SKS Hospital Medical College and Research Center, Mathura, Uttar Pradesh, from 1 July 2025 to 30 June 2026. The study included a total of 51 patients diagnosed with ureteric calculi. Results: A total of 51 patients with obstructive ureteric calculi were included in the study. The mean age of the study population was 45.0 ± 14.36 years. The mean age of patients in the success and failure group was 44.78±14.69 and 45.37 ± 14.16 years respectively, with no significant difference between the success and failure groups. The study population comprised 29 (56.9%) males and 22 (43.1%) females. mean stone size in failure case was(11.52mm) than success cases (9.43mm), Regarding stone laterality, 28 (54.9%) patients had left-sided ureteric calculi, while 23 (45.1%) had right-sided calculi. Based on stone location, 14 (27.5%) patients had lower ureteric stones, 10 (19.6%) had middle ureteric stones, and 27 (52.9%) had upper ureteric stones, making the upper ureter the most common site of obstruction in the present study. Conclusion: The present study identified clinical and radiological factors that influence the success of retrograde double-J (DJ) stent placement in patients with unilateral single obstructing ureteric calculi, while demographic variables such as age, sex, stone laterality, and stone location were not significant predictors. However stone size significantly impacted the success/failure of DJ stenting. Preoperative assessment of these predictors may help identify patients in whom retrograde stenting is likely to be unsuccessful, allowing primary percutaneous nephrostomy to be selected as the initial method of urinary diversion.