Open Access

ARTICLE

Ureteral stenting after routine ureteroscopy: Is earlier stent removal feasible?

Alexander W. Boyko^1,2, Samir Merheb¹, Stephen Hill, Carl A. Ceraolo^1,2, Mark Biebel², Shaun Wason^1,2, David S. Wang^1,2

1 Boston University School of Medicine, Boston, Massachusetts, USA
2 Department of Urology, Boston Medical Center, Boston, Massachusetts, USA
Address correspondence to Alexander W. Boyko, Department of Urology, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118 USA

Canadian Journal of Urology 2021, 28(5), 10865-10870.

Abstract

Introduction: Ureteroscopy and laser lithotripsy is a common treatment option for upper urinary tract calculi. Currently, ureteral stents are placed after uncomplicated ureteroscopy for up to 1 week, but the optimal length of placement is not well defined. Ureteral stents are associated with significant morbidity, particularly stent discomfort. This study aims to determine differences in postoperative unplanned clinic or ED visits based on duration of stent placement.
Materials and methods: This is a single-institution, IRB-approved, retrospective cohort study of 559 ureteroscopy cases with laser lithotripsy for urinary tract calculi performed from 2016 to 2018. The primary outcome was unplanned ED or clinic visits within 30 days following surgery. The patients were separated into three groups based on stent duration: 1 (0-3 days), 2 (4-6 days), and 3 (> 6 days).
Results: Fifty-eight (10.31%) patients experienced an unplanned visit within 30 days of the procedure. There was no significant difference in unplanned visits among groups for stent duration (p = 0.45). A Clavien grade analysis showed no difference in grades between groups (p = 0.59). A Cox regression model showed no difference in risk of unplanned visit comparing those in groups 2 and 3 to group 1 (p = 0.157 and 0.374, respectively). This also remains the case after adjusting for age, sex, and surgeon (p = 0.166 and 0.376, respectively).
Conclusions: We found no difference in unplanned visits in patients based on the duration of stent placement following routine ureteroscopy. Stent removal within 3 days of surgery appears to be sufficient to minimize morbidity after uncomplicated ureteroscopy.

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