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The Effect of Ureteral Stent Placement on Post-Ureteroscopy Complications: A Meta-Analysis
Danil V Makarov, Bruce J. Trock, Mohamad E. Allaf, Brian R. Matlaga
Johns Hopkins University School of Medicine, Baltimore, MD

Introduction: Increasing evidence suggests that ureteral stents may be unnecessary following ureteroscopic stone removal procedures. We performed a meta-analysis that identified all randomized controlled trials examining ureteral stent placement following ureteroscopy, to determine whether the presence or absence of a stent was associated with post-operative complications.
Methods: All randomized clinical trials of ureteral stent placement following ureteroscopy were identified using PubMed. The primary outcome was the percentage of subjects suffering a urologic complication, defined as secondary procedure, emergency department evaluation, or hospital admission. This outcome was compared between the stented (treatment) and unstented (control) arms of each study as a risk difference, pooled as a weighted average across all studies, using both fixed and random-effects models.
Results: Nine trials were identified, comprising a total of 835 subjects. Patients undergoing ureteral stent placement following ureteroscopy had a 4% lower occurrence of urologic complications (risk difference= 0.043). This difference, however, failed to reach statistical significance due to the heterogeneity of the data.
Conclusions: Although there is a slightly lower absolute risk of complication associated with the placement of a ureteral stent following ureteroscopy, the benefit to the stented population does not achieve statistical significance. Therefore, the present literature supports the practice of omitting a ureteral stent following uncomplicated ureteroscopy.

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