Whether post-ureteroscopy stenting is necessary or not?

OBJECTIVE: To verify if post-ureteroscopy (URS) stenting is still necessary as a routine strategy, or if some cases can be treated without.

METHODS: Between August 2004 and April 2005, 85 patients were admitted to the Urology Department at the Nephrology and Urology Center, Al-Thawra Hospital, Yemen with ureteric stones of different size and site. All were scheduled and treated by the ureteroscopy method. According to prospective pure randomization, 45 patients were left non-stented at the end of the operation (non-stented group), while 40 patients were left with stent (stented group).

RESULTS: The ages of the non-stented group ranged between 6-70 years (mean 34.36 ± 15.53), while the size of the stones ranged between 5-20 mm (mean 8.4 ± 3.1). They were 33 males and 12 females. Regarding the site, 26 stones were in the right, and 19 in the left ureter. In the stented group, the ages ranged between 14-70 years (mean 39.35 ± 13.36), while the size of the stones ranged between 6-16 mm (mean 9.9 ± 3.2). They were 34 males and 6 females. Twenty-five stones were in the right ureter, and 15 in the left. Success was 100% in the non-stented group, while it was 39 out of 40 in the stented group. The 2 groups were compared statistically for postoperative analgesia, color clearance of urine and hospital stay, and found significantly different. However, for operative time, the difference was insignificant.

CONCLUSION: When treating ureteric stones by ureteroscopy, postoperative stenting should not be used as routine, but should be limited to those with ureteric injury, bigger sizes and prolonged operative time. The non-stenting method decreases the need for postoperative analgesia, time of color clearance and hospital stay.