Ureteral stenting; after ureteroscopic lithotripsy for ureteric calculi

ABSTRACT

To assess the need for routine ureteral stenting after ureteroscopic lithotripsy. Prospective interventional study. Study was carried out between November 2006 to march 2009 at C.M.H Peshawar and C.M.H Lahore. A total of 100 patients were equally randomized into stented and non stented group. All these patients under went ureteroscopy and lithotripsy. The inclusion criteria was stone 6 to 10 mm. Those patients with large stones previous surgery or ESWL were excluded 8.9 Fr rigid ureteroscope was used with pneumatic lithotripter and 4.7 to 6 Fr double pigtail catheter was placed in stented group for 02 weeks. No ureteral dilator was used and stones were fragmented and no extraction device was used. A complete urine analysis x-ray KUB and USG were performed before and after operation in each patient. Pain score and lower urinary tract symptoms were recorded at the time of admission and three days after the operation. Regarding post operative pain no statistically significant difference was noted between the two groups [p <0.5]. The stone free rate was 100% with hydronephrosis resolved equally in both groups. 20 patients [40%] in stented group complained of at least two irritative bladder symptoms and only 05 patients [10%] in the non stented group experienced bladder discomfort. There was no significant difference in patients reported Haematuria in either group. Two patients in each group developed urinary tract infection. All those patients who were without a stent after uncomplicated ureteroscopic lithotripsy have similar renal function recovery and satisfactory pain reduction and with less irritative symptoms as compared to those with stent. We suggest that it is not necessary to place a ureteral stent in every case after ureteroscopic lithotripsy for stones smaller than 01 cm