Urolithiasis is a very common condition with a high recurrence rate and a significant impact on quality of life. Ureteric stenting is undoubtedly required in ureteroscopies involving considerable bleeding, ureteric trauma, or a high residual stone burden. However, there has been no consistent consensus in prior studies on whether a ureteric stent should be put in after uncomplicated ureteroscopy for stone removal. This study compared the indwelling duration of an open-ended ureteric catheter to standard DJ stenting after uncomplicated ureteroscopic lithotripsy for lower ureteral stones.

This quasi-experimental study was carried out in the Department of Urology, National Institute of Kidney Diseases and Urology, Dhaka, from March 2022 to August 2023, following ethical approval. This study included 150 patients with lower ureteric calculi of less than 10 mm in size who had ureteroscopic stone retrieval after providing informed written consent. Patients in the study were divided evenly into two groups: group A (n=75, insertion of open-ended ureteric catheter following surgery) and group B (n=75, insertion of DJ stent after surgery). Socio-demographic variables, clinical presentation, follow-up VAS pain score, IPSS storage symptoms, urine culture, and postoperative ureteric stricture were all reported. The collected data was recorded in different case record forms and analyzed using SPSS 26.

Age, gender, and ureteral stone size were statistically comparable between the groups. After 1 week (0.97±0.15 vs 2.63±1.53) and 2 weeks (0.56±1.04 vs 2.32±1.71) of surgery, the ureteric catheter group had significantly reduced mean VAS values for flank discomfort compared to D-J stenting (p<0.0001). On the first postoperative day, both groups had similar mean VAS ratings (3.44±1.42 and 3.89±1.47). The IPSS values for frequency, urgency, and nocturia were considerably lower in the ureteric catheter group after 7 and 14 days of follow-up (p<0.0001). The 7th POD urine culture revealed no statistically significant difference between the two groups. E. coli was the most common microorganism in both groups urine cultures. No patients in either group showed evidence of ureteral stricture on an ultrasonogram of the KUB region and IVU (if necessary) performed at the 8th week follow-up visit.

Short-term ureteric catheter placement after uncomplicated ureteroscopic removal of lower ureteric stones can improve postoperative flank pain and irritative symptoms when compared to traditional Double-J stenting. Furthermore, ureteric catheters do not require cystoscopy for removal, which reduces stent-related morbidity, cost, and hospital workload. However, larger studies are recommended.