Double J stenting evaluation after ureteroscopy for urolithiasis

Area of Science:

• Urology
• Endourology
• Nephrolithiasis Management

Background:

• Double J stents are commonly used post-ureteroscopy for urolithiasis to mitigate pain and stenosis.
• However, these stents can negatively impact patient quality of life.
• Their necessity after uncomplicated procedures is debatable.

Purpose of the Study:

• To evaluate and compare postoperative pain and complication rates in patients undergoing ureteroscopy for urolithiasis, with or without a double J stent.
• To determine if double J stenting is mandatory after uncomplicated ureteroscopic interventions.

Main Methods:

• A retrospective analysis of 366 ureteroscopy procedures performed between May 2014 and January 2017.
• Comparison of outcomes between patients who received a double J stent and those who did not.
• Primary outcome: early postoperative pain assessed on a 1-10 scale on postoperative day one.

Main Results:

• No significant difference in postoperative pain scores between stented (22%) and non-stented (17.75%) groups (P=0.398).
• Similar complication rates (29% vs 20.5%, P=0.1181) and rehospitalization rates (0.8% vs 0.9%, P=1) were observed.
• Higher stone burden was noted in the stented group (18.3 vs 9.4mm, P<0.0001).

Conclusions:

• Postoperative double J stenting is not associated with increased pain or complications after uncomplicated ureteroscopy.
• Routine stenting may not be necessary for centimetric stones following ureteroscopy.
• Consideration should be given to omitting stents in select uncomplicated cases to improve patient quality of life.