Study to Determine the Requirement of Ureteral Stent after Uncomplicated Ureteroscopy for Ureteric Stones

Abstract

Aim: The purpose of the study is to determine the necessity of using a ureteral stent later to uncomplicated ureteroscopy in ureteral stones with intracorporeal lithotripsy. Methods: For ureteric stones 170 cases were planned for ureteroscopic lithotripsy at the Urology Department of Sahiwal Teaching hospital, Sahiwal and Abbasi Shaheed Hospital, Karachi for two-years duration from July 2019 to June 2021. 170 patients were encompassed in the analysis after stones fragmentation. The patients were divided randomly into 2 groups: the 1st group (80 patients with a stent) was inserted postoperatively with ureteral stents, while the second group had no stent (90 patients without a stent). Two weeks apart; stents were removed. Each group patients were evaluated for duration of surgery, success, postoperative pain, voiding irritating symptoms, stricture formation and hematuria. Results: Both groups of patients were similar in relation of sex, age and mean size of stones. The mean surgery duration was 40 minutes (15-55) in the stent group and 35 mints (20-45) for the stent-less group. Irritation symptoms during urination were observed in 33.7% in the group with stents and 26.7% in the group without the stent. 23(28.7%) patients in the group placed with stents and 13(14.4%) in the stentless group required two or more analgesics per day immediately after surgery. One patient in the stentless group required re-hospitalization for pain control. Hematuria developed in 11 patients (13.7%) and 9 patients (10%) in the stented and non-stented groups, correspondingly. The stricture formation and stone-free rate did not differ amongst the both groups. Conclusion: Ureteral stenting is not essential after uncomplicated ureteroscopy in the ureteral stone’s treatment with intracorporeal shock wave lithotripsy. While placing the stent in the ureter does not provide any additional benefit, it is inconvenient for the patient in terms of cost and subsequent recovery. Keywords: Ureteral stent, Ureteroscopy, Ureteral calculus.