Abstract
Objective: The objective is to assess the benefits and adverse effects of routine ureteral stenting after uncomplicated ureteroscopic lithotripsy. Material and Methods: Sixty patients with ureteric calculi amenable to ureteroscopic lithotripsy were randomized to an unstented (30 patients) or a stented (30 patients) treatment group, standard ureteroscopic lithotripsy done using 8 French semirigid ureteroscope, and pneumatic lithotripter used to fragment the stones. They were followed up for postoperative flank pain, lower urinary tract symptoms (LUTS) and hematuria. Results: There was no significant difference in the mean age (stenting 37.8 year and 33.5 year unstenting) of patients, gender and stone size in both groups. No significant difference in the mean flank pain within 3 days postoperative, while at day 14 postoperative flank pain for stenting group was significant (P = 0.03). Dysuria and urgency were high for stenting group (P = 0.002 and 0.011). Hematuria within 3 and 14 days was higher in the stenting group. Conclusion: After uncomplicated ureteroscopy, stents can be safely omitted. Unstented patients have significantly fewer LUTS, haematuria and flank pain.
Highlights
Urinary stone disease is the third most common affliction of the urinary tract [1]
The value of stenting is the prevention of ureteral obstruction and renal colic, which may develop following stone retrieval, it may aid in the passage of stone fragments and prevent delayed ureteral stricture, but its use may be accompanied by troublesome urinary symptoms [10]-[12]
Flank pain at 3rd day was nearly the same between the groups, while at 14th day it was higher in the stented group and statistically significant (P value 0.038)
Summary
Urinary stone disease is the third most common affliction of the urinary tract [1]. It affects 5% - 12% of the population during their lifetime. The value of stenting is the prevention of ureteral obstruction and renal colic, which may develop following stone retrieval, it may aid in the passage of stone fragments and prevent delayed ureteral stricture, but its use may be accompanied by troublesome urinary symptoms [10]-[12]. Routine placement of a ureteral stent following uncomplicated Ureteroscopic removal of distal ureteral stones was not necessary by some authors [15]. The aim of this randomized clinical trial is to assess the need for routine placement of ureteral stent after uncomplicated ureteroscopy and to assess the outcomes among stented and unstented patients
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