STENT USE WITH EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY

Since the advantages of using ureteral stents in conjunction with extr acorporeal shock wave lithotripsy were first recognized, the growing d emand for outpatient stone treatment has made stent use much more freq uent. However, prophylactic stent placement must be judicious to maxim ize success and minimize associated morbidity. Recent controlled retro spective studies and randomized trials showed that ureteral stenting d oes not increase the stone-free rate or reduce the complication rate f or stones less than 2 cm in size, yet in such cases, there are increas ed morbidities such as urinary urgency, frequency, stent migration, an d encrustation. However, in patients with stones larger than 2 cm, Typ e C4 staghorn calculi, or stones associated with a solitary kidney, pr ophylactic stent placement may reduce the complication rates arising f rom these larger stone burdens. Finally, ureteral stenting may be help ful for stone localization or manipulation.