A prospective randomized trial comparing non-stented versus routine stented ureteroscopic holmium laser lithotripsy

Objectives: To determine whether post-operative ureteral stenting is necessary after ureteroscopic lithotripsy for the treatment of middle and distal ureteral calculi. Methods: The trial was carried out in the Department of Urology of West China Hospital, Sichuan University, Chengdu, China, between May 2005 and May 2006. A total of 110 patients underwent uncomplicated ureteroscopic lithotripsy. After the procedure, patients were randomized to a non- stented (n=55), or stented (n=55) group. The stent was routinely placed for 3 weeks. Outcome measures included operative time, visual analog scale, post- operative analgesic requirements, complications, and the stone-free rate. Results: The incidence of hematuria was higher and the operative time was longer in the stented group compared to the non-stented group. At 48 hours post-operatively, the symptoms of flank pain and abdominal pain were significantly greater in the stented group. There was no statistical difference in the 2 groups, in terms of irritative symptom, analgesic use, and complications. The stone-free rate was almost 100% in both groups. Conclusion: Uncomplicated ureteroscopic lithotripsy can be safely performed without the placement of a ureteral stent. Patients without stents had less operative time, pain and hematuria.