Role of prophylactic ureteric stents in colorectal surgery

Ureteric injury is a feared complication in colorectal surgery, with a reported incidence of 0.2%-7.6%. Prophylactic ureteric catheter placement has the advantage of facilitating intraoperative ureter identification and assisting in immediate injury recognition and repair. However, its use has been controversial because of fear of ureteric damage during catheter insertion and postoperative urinary complications such as obstructive oliguria and urinary tract infection. Although the exact indications for prophylactic catheter placement are not clearly defined, it is generally used for reoperative cases, large tumors, previous radiation therapy, diverticulitis, fistulas, Crohn's disease and obesity. Herein, we review the incidence and risk factors for ureteric injury, the role of prophylactic ureteric stents and the complications and costs associated with its use in both open and laparoscopic colorectal surgery.