The purpose of our trial was to evaluate whether
stents could be eliminated after uncomplicated ureteroscopic
lithotripsy for ureteral stones and the indications of ureteral
stent placement. A total of 228 patients underwent uncomplicated ureteroscopic intracorporeal
lithotripsy. After the procedures, patients without marked ureteral
edema, polypoid change or
stent placement were treated as a control group. The other patients were randomized to two groups. Patients were followed on the first postoperative day, 6 and 12 weeks, postoperatively. In stented cases the
stent was removed after 1 week. Outcome measures included visual analog scale assessment, postoperative
analgesic requirements, complications and the stone-free rate. On the first postoperative day the symptoms of
flank pain,
dysuria and frequency were significantly greater in the stented group (P < 0.0001). The overall perioperative complication rate, including
fever,
pyuria, flank and loin
pain, was 3.3% (3/90) in group 1, 16.9% (12/71) in group 2, and 41.8% (28/67) in group 3. We believe that in selected patients undergoing ureteroscopy for ureteral stone,
stents can be safely omitted. Patients without
stents have significantly less
stent-related symptoms and are not at higher risk of complications with smooth ureteral mucosa. When there is ureteral
edema or polypoid change with
pyuria, ureteral
stents should be indwelled to avoid severe postoperative complications.