Abstract

Objectives. We compared outcome and complications after uncomplicated ureteroscopic treatment of distal ureteral calculi with or without the use of ureteral stents. Materials and Methods. 117 patients, prospectively divided into three groups to receive a double j stent (group 1, 42 patients), ureteral stent (group 2, 37 patients), or no stent (group 3, 38 patients), underwent ureteroscopic treatment of distal ureteral calculi. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS), analgesia need, rehospitalization, stone-free rate, and late postoperative complications were all studied. Results. There were no significant differences in preoperative data. There was no significant difference between the three groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in the nonstented group. When comparing group 1 and group 3, patients with double j stents had statistically significantly more bladder pain (P = 0.003), frequency/urgency (P = 0.002), dysuria (P = 0.001), and need of analgesics (P = 0.001). All patients who underwent imaging postoperatively were without evidence of obstruction or ureteral stricture. Conclusions. Uncomplicated ureteroscopy for distal ureteral calculi without intraoperative ureteral dilation can safely be performed without placement of a ureteral stent.

Highlights

  • Nowadays ureteroscopy has become the treatment of choice for managing ureteral stones, specially mid and distal ones [1].There is no consensus on placing a ureteral catheter after uncomplicated ureteroscopy and it is still controversial

  • The aim of our study was to assess the need for routine ureteral stenting after uncomplicated ureteroscopic stone removal, evaluating the patient characteristics, stone features, complications, and treatment outcome among stented and unstented patients

  • The need of analgesics in postoperative time, the rate of rehospitalisation, and the appearence of an ureteral stricture

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Summary

Introduction

Nowadays ureteroscopy has become the treatment of choice for managing ureteral stones, specially mid and distal ones [1]. There is no consensus on placing a ureteral catheter after uncomplicated ureteroscopy and it is still controversial. It is a routine justified by the belief that this practice decreases ureteral stricture formation, protects the kidney, and minimizes postoperative pain [2]. The use of stents is accompanied by significant morbidity, including pain, infection, and irritative voiding symptoms [3, 4]. The aim of our study was to assess the need for routine ureteral stenting after uncomplicated ureteroscopic stone removal, evaluating the patient characteristics, stone features, complications, and treatment outcome among stented and unstented patients

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