Early versus Delayed Removal of Catheter for Holmium Laser Lithotripsy in Day Surgery: A Prospective Study

The aim of the study was to evaluate the safety and efficacy of same-day versus next-day urinary catheter removal following ureteroscopic holmium laser lithotripsy (with routine double-J stent placement) in a day-surgery setting.

In this comparative study, 191 patients undergoing day-care holmium laser lithotripsy were allocated to next-day (n = 94) or same-day (n = 97) extubation groups. Outcomes included catheter retention duration, post-removal complications, voiding function, and recovery parameters.

No catheter-related adverse events occurred in either group. No significant differences were observed in first void volume, catheter reinsertion rates, post-catheter removal urination, lower abdominal distension, or urethral pain (p > 0.05). The same-day group demonstrated significantly shorter catheter retention time (p < 0.001) and earlier postoperative ambulation (p < 0.001). Notably, time to spontaneous voiding was prolonged in the same-day group (p = 0.009), though all values remained within physiological ranges.

Same-day catheter removal after ureteroscopic holmium laser lithotripsy, even with routine double-J stent placement, safely reduces indwelling time and promotes early mobilization without increasing the risk of urinary retention or exacerbating stent-related discomfort. The protocol is feasible for day-surgery populations.