Objective: To compare intra- and postoperative data of patients who underwent ureterorenoscopy (URS) with an access sheath, with and without postoperative stenting.
Methods: We retrospectively identified patients who underwent flexible URS with a ureteral access sheath between January 2102 and January 2013. Two surgeons performed all cases; one who routinely stents after flexible ureteroscopy and a second who selectively stents. Fifty-one patients who were stented and 51 patients not stented after URS were enrolled in this study. Patients were matched by operative time as a surrogate measure of complexity of the procedure. Intra- and postoperative data were compared. We also analyzed if preoperative stenting or sheath diameter had any effect on postoperative pain score for each group.
Results: Patients in the stented group were older (P <.001), had larger ureteral access sheaths (P <.001), and greater stone burden (P <.001). Despite this, the stented group had lower pain scores (4.5 ± 3.2 vs 8.9 ± 3.2; P = .025) and were less likely to seek medical assistance for pain than the unstented patients (26.3% vs 3.9%; P = .007). Patients who were prestented before ureteroscopy had lower pain scores than those who were not prestented in the group that did not receive a postoperative stent (4.2 ± 3.4 vs 6.6 ± 2.8; P = .047).
Conclusion: Postoperative stenting after flexible URS with a ureteral access sheath seems to decrease postoperative pain. Patients might be selected for no ureteral stent if they were prestented before the procedure, and the URS was uneventful.
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