Ureteral stenting after uncomplicated ureteroscopic lithotripsy: pros and cons

Dr. Slavisa Savić¹, prof. dr. Vinka Vukotić¹, prof.dr. Miodrag Lazić¹, dr Dusan Spasic¹ and dr. Natasa Savić¹,

¹Department of Urology “Dr. D.Misović” Clinical Center, Belgrade, Serbia


Introduction: To evaluate the necessity, potential beneficial and adverse effects of ureteral stent placement after uncomplicated ureteroscopic lithotripsy.

Materials and Methods: A total of 139 patients who underwent the ureteroscopic lithotripsy (URSL) were retrospectively evaluted in this study. Patients divided into two groups: -stented (cases, 70 patients) and – unstented (controls, 69 patients). Between these two groups, the measured outcomes included stone free rate, postoperative patient pain validated by scale, lower urinary tract symptoms (LUTS), the need for unplanned hospital care, complications related to the stent and return to normal physical activities. The modified the Clavien – Dindo Classification of Surgical Complications was used for evaluating peri-operative and postoperative complications.

Results: A successful outcome, defined as being stone-free for 12 weeks, was achieved in 65 (93%) patients in cases, and 66 (96%) patients in controls. The stone-free rate, mean operative time and mean hospitalization time showed no difference between these two groups. LUTS was more frequent complain in stented group, although without statistically significant difference. There was statistically significant difference in mean visual analog pain score (VAS) and in use of non narcotic analgetic between groups. Namely, on the operation day and until postoperative day (POD) 3 and POD 5, pain score was much higher in cases than in controls (P=0.001) and non narcotic (P=0.001) use were frequently necessary in stented group.

Conclusion: Routine placement of ureteral stent after uncomplicated ureteroscopy is not mandatory. It may be related with stent side effects, in the form of irritative LUTS.