Routine ureteral stenting after ureteroscopy for ureteral lithiasis: Is it really necessary?

Purpose: We assessed the cost-effectiveness of routine ureteral stenting after ureteroscopic stone removal. Materials and Methods: Of 295 consecutive patients who underwent rigid ureteroscopic stone removal 133 in group 1 and 162 in group 2 were randomized to receive and not receive a stent, respectively, after the procedure. Operative time, stone size, stone location, success rate, postoperative pain and complications were analyzed in each group. Results: There were no statistically significant differences in the 2 groups regarding stone size, stone location, success rate, postoperative pain or complications. However, in group 1 operative time was significantly longer than in group 2 (chi-square test p = 0.019). The hospital charge per patient when placing and not placing a stent after ureteroscopy for stone removal was $9,900.95 and $3,661.78, respectively. The female patients with a stent without a suture required an extra charge for stent removal in the operating room, while no men had a stent with a suture. Conclusions: Routine catheter placement after ureteroscopic stone removal increased operative time and did not seem to improve patient outcome. The cost was 30% that without a stent.