Ureteral Stenting after Flexible Ureterorenoscopy with Ureteral Access Sheath; Is It Really Needed?: A Prospective Randomized Study
Wichien Sirithanaphol MD*, Siros Jitpraphai MD*, Tawatchai Taweemonkongsap MD*, Chaiyong Nualyong MD*, Ekkarin Chotikawanich MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : The aim of this study was to compare perioperative outcomes of patients who underwent uncomplicated flexible
ureterorenoscopy with ureteral access sheath, with and without postoperative ureteral stenting.
Material and Method: Between April to December 2014, 50 consecutive patients underwent flexible ureterorenoscopy were
enrolled in the study. The patients who had indications for postoperative ureteral stent or those who had ureteric complications
during procedure that needed postoperative ureteral stenting were excluded. Thirty-eight eligible patients were randomized
into a ureteral stent or non-ureteral stent group following flexible ureterorenoscopy with ureteral access sheath. Patient
demographic data, operative data and perioperative outcomes were evaluated. Irritative voiding symptom score was
calculated by using irritative domains of International Prostate Symptom Score (IPSS).
Results : Baseline characteristics were well balanced between both groups. There was no significant difference in postoperative
pain, analgesic requirement, postoperative fever, urinary tract infection, irritative voiding symptom scores and length of
hospital stay between the two groups. Three patients in stent group had unplanned hospital visits. Operative time was
significantly shorter in non-stent group: 52+22 vs. 71+29 min (p = 0.02).
Conclusion : Non-ureteral stenting is safe and feasible in uncomplicated cases after flexible ureterorenoscopy with ureteral
access sheath compared to stenting.
Keywords : Ureteral access sheath, Ureteral stenting, Flexible ureterorenoscopy, Safety
