Comparison of ureteral stent diameters on ureteral stent-related symptoms: A systematic review and meta-analysis

Ureteral stents may induce complications that may disrupt the quality of life of patients. Several factors that may cause these symptoms are the design, material, diameter, length, and position of the stent. The impact of its diameter varies among current reports, thus we aimed to compare the symptoms between 6 Fr and 5 Fr or less ureteral stents. A systematic search and screening were performed in the Embase, Medline, and Scopus databases. Eligible studies included randomized controlled trials (RCTs). Cochrane risk of bias tool 2 was used to evaluate the studies. Seven RCTs were included in this review. Urinary symptoms were discussed qualitatively. From the included studies, the use of a relatively smaller stent diameter yielded an overall lower rate of Ureteral Stent Symptom Questionnaire score and urinary symptoms compared to a stent with a larger diameter. There was no significant difference in migration rate (OR: 1.55, 95% CI: 0.67-3.57, P ¼ .31), visual analogue scale (MD: 0.42, 95% CI: 2.04 to 1.20, P ¼ .61), analgesic use duration (MD: 0.06, 95% CI: 1.02 to 0.91, P ¼ .91), and stone-free rate probability (OR: 1.29, 95% CI: 0.48-3.45, P ¼ .62) between patients with 5 Fr or less and 6 Fr ureteral stents. Smaller ureteral stent size is suggested for reducing ureteral stent-related symptoms, without significant differences in the incidence of stent migration, pain, analgesic use, and stone-free rate.