Is ureteral stenting after ureteroscopy really necessary?

ABSTRACT

To evaluate the use of a Double J stent catheter after uncomplicated ureteroscopy regarding the need for pain killers, lower urinary tract symptoms, fever and the recurrence of stones. Over a period of one year from January 2007 through January 2008, all patients who underwent uncomplicated ureteroscopies at Prince Hussein Urology Center, King Hussein Medical Center were studied. Group A were not stented and group B were stented. The need for pain killers, lower urinary tract symptoms, onset of fever and recurrence of stones were analyzed. A total of 187 patients had uncomplicated ureteroscopies. Seventy-eight [41.7%] patients were stented [Group A] and 109 [58.3%] patients were not stented [Group B]. In the recovery room there was no difference in the need for pain killers but there was a great difference in the first four weeks postoperatively where only 20.2% needed pain killers in group B compared to 62.8% in group A. Only 14.6% of patients in group B had lower urinary tract symptoms while 79.5% in group A were symptomatic. The onset of urinary tract related fever was lower in group B compared to group A [0.91% compared to 3.8%]. There was no difference in stone recurrence at three months between the two groups. Stent placement after uncomplicated ureteroscopy is unnecessary, has no added benefit and is associated with increased morbidities. Good clinical judgment is needed for intraoperative patient evaluation and the decision for the need of ureteric stent