Introduction: This study aims to evaluate the impact of preoperative ureteral stenting on post-operative outcomes, especially the incidence of urinoma, in patients with complex renal tumours undergoing nephron-sparing surgery (NSS). Methods: A retrospective analysis of 35 patients received preoperative ureteral stenting prior to NSS for complex tumours at the University Hospital of Würzburg between 2002 and 2021. A control group of 115 patients was established through 1:3 propensity score matching based on age, gender, T-stage, and RENAL score. Clinical parameters, surgical outcomes, and complications were assessed, and statistical comparisons were performed using the unpaired Student’s t test and chi-square test. Results: While both groups showed comparable tumour complexity (RENAL: 7 vs. 7, p = 0.58; PADUA: 9 vs. 8, p = 0.62), there were no significant differences in median hospital stay (12 vs. 11; p = 0.068), surgical time (183 vs. 190 min; p = 0.37), post-operative haemoglobin levels (11 g/dL vs. 11.1 day/dL; p = 0.9), and renal function (GFR 65 mL/min/m2 in both groups). Moreover complication severity during NSS, defined by Clavien-Dindo classification, was similar (none vs. grade I; p = 0.29). No significant difference in the rate of urinoma was observed (11% vs. 4%, p = 0.93). Conclusions: This study found no significant benefits of preoperative ipsilateral ureteral stenting on post-operative outcomes, particularly concerning the development of urinoma. Given these findings, preventive ureteral stenting is not recommended prior to partial kidney resection for complex renal tumours.

1.
Fornara
P
,
Hoda
MR
.
[Renal cell carcinoma]
.
Urologe
.
2011
;
50
(
S1
):
219
22
.
2.
Bellido
JA
,
Palou
J
,
Hübner
M
,
Pascual
M
,
Sagristá
R
,
Martínez
E
, et al
.
[Early ultrasound detection of renal tumors in patients with end stage renal disease in dialysis]
.
Arch Esp Urol
.
2007
;
60
(
9
):
1.079
83
.
3.
Volpe
A
,
Finelli
A
,
Gill
IS
,
Jewett
MAS
,
Martignoni
G
,
Polascik
TJ
, et al
.
Rationale for percutaneous biopsy and histologic characterisation of renal tumours
.
Eur Urol
.
2012
;
62
(
3
):
491
504
.
4.
MacLennan
S
,
Imamura
M
,
Lapitan
MC
,
Omar
MI
,
Lam
TBL
,
Hilvano-Cabungcal
AM
, et al
.
Systematic review of oncological outcomes following surgical management of localised renal cancer
.
Eur Urol
.
2012
;
61
(
5
):
972
93
.
5.
Riggs
SB
,
Larochelle
JC
,
Belldegrun
AS
.
Partial nephrectomy: a contemporary review regarding outcomes and different techniques
.
Cancer J
.
2008
;
14
(
5
):
302
7
.
6.
Bragayrac
LA
,
Abbotoy
D
,
Attwood
K
,
Darwiche
F
,
Hoffmeyer
J
,
Kauffman
EC
, et al
.
Outcomes of minimal invasive vs open radical nephrectomy for the treatment of locally advanced renal-cell carcinoma
.
J Endourol
.
2016
;
30
(
8
):
871
6
.
7.
Xia
L
,
Wang
X
,
Xu
T
,
Guzzo
TJ
.
Systematic review and meta-analysis of comparative studies reporting perioperative outcomes of robot-assisted partial nephrectomy versus open partial nephrectomy
.
J Endourol
.
2017
;
31
(
9
):
893
909
.
8.
Grivas
N
,
Kalampokis
N
,
Larcher
A
,
Tyritzis
S
,
Rha
KH
,
Ficarra
V
, et al
.
Robot-assisted versus open partial nephrectomy: comparison of outcomes. A systematic review
.
Minerva Urol Nefrol
.
2019
;
71
(
2
):
113
20
.
9.
Petrut
B
,
Bujoreanu
CE
,
Hardo
VV
,
Barbos
A
,
Fetica
B
.
Laparoscopic cytoreductive nephrectomy and adrenalectomy for metachronous RCC metastases-Case report
.
Int J Surg Case Rep
.
2020
;
74
:
268
72
.
10.
Finelli
A
,
Kaouk
JH
,
Fergany
AF
,
Abreu
SC
,
Novick
AC
,
Gill
IS
.
Laparoscopic cytoreductive nephrectomy for metastatic renal cell carcinoma
.
BJU Int
.
2004
;
94
(
3
):
291
4
.
11.
Daliani
DD
,
Tannir
NM
,
Papandreou
CN
,
Wang
X
,
Swisher
S
,
Wood
CG
, et al
.
Prospective assessment of systemic therapy followed by surgical removal of metastases in selected patients with renal cell carcinoma
.
BJU Int
.
2009
;
104
(
4
):
456
60
.
12.
Sharma
G
,
Sharma
AP
,
Tyagi
S
,
Bora
GS
,
Mavuduru
RS
,
Devana
SK
, et al
.
Robot-assisted partial nephrectomy for moderate to highly complex renal masses. A systematic review and meta-analysis
.
Indian J Urol
.
2022
;
38
(
3
):
174
83
.
13.
Leslie
S
,
Gill
IS
,
de Castro Abreu
AL
,
Rahmanuddin
S
,
Gill
KS
,
Nguyen
M
, et al
.
Renal tumor contact surface area: a novel parameter for predicting complexity and outcomes of partial nephrectomy
.
Eur Urol
.
2014
;
66
(
5
):
884
93
.
14.
Girard
F
,
Thanigasalam
R
,
Theveniaud
PE
,
El Hajj
A
,
Eimer
C
,
Sibileau
E
, et al
.
Prolonged urinary leakage after partial nephrectomy: a novel management pathway
.
Urology
.
2014
;
83
(
2
):
485
8
.
15.
Ramani
AP
,
Desai
MM
,
Steinberg
AP
,
Ng
CS
,
Abreu
SC
,
Kaouk
JH
, et al
.
Complications of laparoscopic partial nephrectomy in 200 cases
.
J Urol
.
2005
;
173
(
1
):
42
7
.
16.
Spana
G
,
Haber
GP
,
Dulabon
LM
,
Petros
F
,
Rogers
CG
,
Bhayani
SB
, et al
.
Complications after robotic partial nephrectomy at centers of excellence: multi-institutional analysis of 450 cases
.
J Urol
.
2011
;
186
(
2
):
417
21
.
17.
Israel
GM
,
Hecht
E
,
Bosniak
MA
.
CT and MR imaging of complications of partial nephrectomy
.
Radiographics
.
2006
;
26
(
5
):
1419
29
.
18.
Yoo
S
,
You
D
,
Jeong
IG
,
Song
C
,
Hong
B
,
Hong
JH
, et al
.
Does ureteral catheter insertion decrease the risk of urinary leakage after partial nephrectomy in patients with renal cell carcinoma
.
Clin Genitourin Cancer
.
2017
;
15
(
4
):
e707
12
.
19.
Meeks
JJ
,
Zhao
LC
,
Navai
N
,
Perry
KT
Jr
,
Nadler
RB
,
Smith
ND
.
Risk factors and management of urine leaks after partial nephrectomy
.
J Urol
.
2008
;
180
(
6
):
2375
8
.
20.
Bove
P
,
Bhayani
SB
,
Rha
KH
,
Allaf
ME
,
Jarrett
TW
,
Kavoussi
LR
.
Necessity of ureteral catheter during laparoscopic partial nephrectomy
.
J Urol
.
2004
;
172
(
2
):
458
60
.
21.
Zargar
H
,
Khalifeh
A
,
Autorino
R
,
Akca
O
,
Brandão
LF
,
Laydner
H
, et al
.
Urine leak in minimally invasive partial nephrectomy: analysis of risk factors and role of intraoperative ureteral catheterization
.
Int Braz J Urol
.
2014
;
40
(
6
):
763
71
.
22.
Kane
LT
,
Fang
T
,
Galetta
MS
,
Goyal
DKC
,
Nicholson
KJ
,
Kepler
CK
, et al
.
Propensity score matching: a statistical method
.
Clin Spine Surg
.
2020
;
33
(
3
):
120
2
.
23.
Arora
M
,
Randhawa
LS
,
Lakhera
D
,
Thakker
V
,
Abhishek
KA
,
Singh
D
, et al
.
Interobserver reproducibility of RENAL nephrometry score in comparison to simplified PADUA Renal nephrometry score
.
Urol Ann
.
2023
;
15
(
4
):
373
82
.
24.
Polascik
TJ
,
Pound
CR
,
Meng
MV
,
Partin
AW
,
Marshall
FF
.
Partial nephrectomy: technique, complications and pathological findings
.
J Urol
.
1995
;
154
(
4
):
1312
8
.
You do not currently have access to this content.