Routine placement of ureteral stents is unnecessary after ureteroscopy forurinary calculi

Objectives. To report a matched comparison of patients with and without ste nting after ureteroscopy for calculi, including middle or proximal ureteral and renal calculi. The elimination of routine stenting after ureteroscopy would prevent stent pain, minimize the need for re-instrumentation, and red uce costs-as long as efficacy and safety are not diminished. Methods. Of 318 patients who underwent ureteroscopy, 81 (25%) did not have a ureteral stent placed. Of those, 51 were suitable for analysis and includ ed patients with distal ureteral (n = 22), middle or proximal ureteral (n = 11), and renal calculi (n = 18). This cohort was matched to a stented grou p by stone size and location. Results. The preoperative characteristics of the groups were similar. A sto ne-free rate of 86% and 94% was achieved in the stented and nonstented grou ps, respectively (P = 0.32). Complications in the nonstented group were les s frequent (flank pain in 3 and postoperative nausea in 1) than in the sten ted group (hospital visits for flank pain in 12, persistent nausea and vomi ting in 1, sepsis in 1, perinephric hematoma in 1, and urinary retention in 1) (total of 4 versus 16, P = 0.025). Conclusions. Ureteroscopy for distal ureteral stones without ureteral stent placement has been previously described. Our experience expands to include the elimination of stent placement after ureteroscopy for middle or proxim al ureteral (22%) and renal (35%) calculi. Our data suggest that after uret eroscopies with short operative times and minimal ureteral trauma, ureteral stents may not be necessary, even if proximal ureteral or renal ureterosco py has been performed. UROLOGY 57: 639-643, 2001. (C) 2001, Elsevier Scienc e Inc.