LOWER URETERIC STONES

Abstract

Aims & Objectives: Placement of a ureteral stent is routinely done followed byureteroscopy. Recently, many researchers have questioned routine stenting after ureteroscopyfor management of distal ureteric stones? We report our outcomes of a randomized studycomparing ureteroscopy with and without placement of stents for management of distalureteric stones. Study Design: Randomized controlled trial. Setting: Department of Urology,Jinnah Hospital/ Allama Iqbal Medical College, Lahore. Period: March 2013 to February, 2015.Materials & methods: Total 155 patients were prospectively divided into three groups to receivea double J stent (Group I, 54 patients), ureteral stent (Group II, 50 patients) and no stent (GroupIII, 51 patients), underwent ureteroscopic treatment of distal ureteric stones. Characteristics ofstones, operation time, postoperative pain, lower urinary tract symptoms, and analgesia needfor postoperative pain, hospitalization, stone free rate and late postoperative complicationswere all studied. Results: There were no significant differences in preoperative data. Therewas no statistical significant difference between three groups regarding hematuria, fever, flankpain, urinary tract infection and re-hospitalization. At 48 hours and 1 week, frequency/ urgencyand dysuria were significantly less group III. When comparing Group I and Group III, patientswith double J stent has statistically significant more bladder pain 0, frequency/ urgency 0,dyusuria 0 and need of analgesia 0. All patients of the three groups assessed postoperativelyby imaging did not suffer any obstruction or ureteral stricture. Conclusion: Uncomplicatedureteroscopy without stent placement for treatment of distal ureteral stones is a safe procedure.Patients without stents have significantly fewer irritative bladder symptoms and are not at riskof complications.