A prospective randomized trial comparing non-stented versus routine stented ureteroscopic holmium laser lithotripsy

To determine whether post-operative ureteral stenting is necessary after ureteroscopic lithotripsy for the treatment of middle and distal ureteral calculi.

The trial was carried out in the Department of Urology of West China Hospital, Sichuan University, Chengdu, China, between May 2005 and May 2006. A total of 110 patients underwent uncomplicated ureteroscopic lithotripsy. After the procedure, patients were randomized to a non-stented (n=55), or stented (n=55) group. The stent was routinely placed for 3 weeks. Outcome measures included operative time, visual analog scale, post-operative analgesic requirements, complications, and the stone-free rate.

The incidence of hematuria was higher and the operative time was longer in the stented group compared to the non-stented group. At 48 hours post-operatively, the symptoms of flank pain and abdominal pain were significantly greater in the stented group. There was no statistical difference in the 2 groups, in terms of irritative symptom, analgesic use, and complications. The stone-free rate was almost 100% in both groups.

Uncomplicated ureteroscopic lithotripsy can be safely performed without the placement of a ureteral stent. Patients without stents had less operative time, pain and hematuria.