IS STENTING FOLLOWING URETEROSCOPY FOR REMOVAL OF DISTAL URETERAL CALCULI NECESSARY?

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Abstract
We determine the morbidity associated with no stent placement following uncomplicated ureteroscopy for removal of distal ureteral calculi. A total of 93 patients undergoing uncomplicated, complete removal of distal ureteral calculi were contacted 1 to 3 days and 7 to 10 days postoperatively to determine analgesic requirements and time of return to normal activity. Radiological followup consisted of an excretory urogram or renal ultrasound 8 weeks postoperatively. Of 93 patients 40 (43%) had no discomfort postoperatively. Of the 53 patients who had discomfort 45 (85%) had mild discomfort only, controlled with oral analgesics. When discomfort occurred it resolved in 41 patients (77%) in 2 days or less. Of 12 patients who required intravenous narcotics postoperatively 5 required preoperative hospitalization for the narcotics and were still hospitalized at the time of stone removal. None of the 59 patients who had followup excretory urogram or renal ultrasound has had a newly identified ureteral stricture to date. In the majority of patients undergoing uncomplicated ureteroscopy for removal of distal ureteral calculi postoperative discomfort is modest, lasts less than 2 days and is easily controlled with oral analgesics. Stricture formation has not been identified. We do not believe that routine placement of a ureteral stent following uncomplicated ureteroscopy for distal ureteral calculi is necessary.