Post-ureteroscopy ureteric stents are commonly used after operative management of kidney stone disease to maintain internalised renal drainage of which the common variety used is a double-J conventional ureteric stent. A variety of alternative ureteric stents have been used in practice including stents on extraction string (SOES), ureteric catheters and magnetic ureteric stents. The latter of which have shown to have increased benefits over conventional stents, especially around the ease and cost-effectiveness of removal. However, there is a paucity of data comparing these alternative methods directly.

A retrospective analysis of patients who received magnetic stents or SOES after ureteroscopy for kidney stone disease at Royal North Shore Hospital (RNSH) over two years (2021-2022) was undertaken since introduction of magnetic stents at RNSH in 2021, identifying 118 patients for analysis. A review of medical records was performed to extract patient demographic data (age, sex), the type of stent used, stent dwell time, and 30-day morbidity and mortality. Adult patients (18 years of age or older) with unilateral kidney stone disease undergoing uncomplicated unilateral ureteroscopy with post-operative ureteric stent insertion were included.

There was a statistically significant reduction in stent dwell time noted with SOES (median = 5 days, IQR 3-7) compared to magnetic stents (median = 13 days, IQR 9-16). However, this may be reflective of the increased rates of stent migration (n = 9/98) and premature removal (n=18/98) compared to the magnetic stent population (n = 0/20) as well as patients having the option to self-remove their stent at home. We identified statistically significant lower rates of complication within 30 days for magnetic stents (0/20 = 0%) compared to SOES (21/98 = 21.4%) (P < 0.05). Additionally, our results reflect the lower risk of detachment and dislodgement in magnetic stents compared to SOES. When comparing rates of complicated removal requiring flexible cystoscopy there were no significant differences found between the two methods.

This is the first retrospective review directly comparing their use demonstrating decreased 30-day complication rates and stent dislodgement rates in magnetic stents compared to SOES. In future, a prospective study accounting for cost-effectiveness, patient satisfaction, and waitlist management could provide greater insight into determining if magnetic stents are more suitable than SOES for stenting post-ureteroscopy