Outcomes and Complications from a Randomized Controlled Study Comparing Conventional Stent Placement Versus No Stent...

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Ureteric stent insertion after ureteroscopic lithotripsy (URSL) is common but its necessity after uncomplicated procedures is debated.
• The definition of an uncomplicated URSL also remains unclear.

Purpose of the Study:

• To compare the efficacy, safety, and morbidity of omitting ureteral stents versus conventional stenting after uncomplicated retrograde semirigid URS for distal ureteral calculi ≤1 cm.
• To assess complication rates, emergency visits, secondary interventions, and pain.

Main Methods:

• 104 patients undergoing uncomplicated URSL were randomized into a conventional stented group (CSG) and a nonstented group (NSG).
• Validated questionnaires (IPSS, IIEF-5, MSHQ-EjD/FSFI) assessed lower urinary tract symptoms and sexual function preoperatively and at 4 weeks.
• Pain was measured using a visual analogue scale (VAS); emergency visits and secondary interventions were recorded.

Main Results:

• The nonstented group showed significant improvements in urinary tract symptoms (IPSS domains, QoL) and sexual function (IIEF-5, MSHQ-EjD, FSFI) compared to the stented group.
• No significant differences were observed in emergency visits, readmissions, secondary interventions, or pain scores between the groups.
• The nonstented group experienced fewer stent-related symptoms.

Conclusions:

• Nonplacement of ureteral stents after uncomplicated URSL effectively reduces stent-related symptoms and preserves quality of life.
• Omitting stents does not increase postoperative risks, making it a viable option for selected patients.