Is a ureteral stent required before flexible ureteroscopy?

Abstract

BackgroundTo retrospectively evaluate the therapeutic effectiveness and safety of flexible ureteroscopes without preoperative ureteral stent placement.MethodsA total of 243 patients who had undergone flexible ureteroscopy (fURS) lithotripsy were reviewed. The patients were divided into two groups: 119 patients without preoperative ureteral stent placement were set as group A; and the remaining 124 patients who received preoperative ureteral stent placement were set as group B. The operative time, length of hospital stay, hospital costs, stone-free rates (SFRs), complications, and re-operation rates of the two groups were respectively compared.ResultsPairwise analysis indicated the following: the average operative time of group A was longer than that of group B (66.53±10.19 versus 59.85±9.85 min, P=0.0001), the average length of hospital stay of group A was considerably shorter than that of group B (6.56±0.90 versus 10.67±1.50 d, P=0.0001), the SFRs of group A were significantly lower than those of group B at 3 days postoperatively (36.1%, 43/119 versus 51.6%, 64/124, P=0.0034), and the average hospital costs were substantially lower in group A than those in group B (18,756 versus 23,450 RMB, P=0.0001). However, there were no notable differences observed in the following: SFRs between the groups at 1 month postoperatively (84.0%, 100/119 of group A versus 85.5%, 106/124 of group B, P=0.895), complications rates (20.1%, 26/124 in group A versus 20.1%, 23/114 in group B, P=0.597), and re-operation rates (15.1%, 18/119 in group A versus 16.9%, 21/124 in group B, P=0.558).ConclusionsThese results indicated that fURS without preoperative ureteral stent placement is safe and effective for the treatment of upper urinary calculi.