Randomized, multicenter trial of ureteral stent placement vs. stent omission after ureteroscopy for renal stones

Authors

  • Seth K. Bechis UC San Diego
  • Daniel A. Wollin Harvard University
  • Marcelino Rivera Indiana University
  • Johann Ingimarsson Landspitali University Hospital
  • Kymora Scotland University of California Los Angeles
  • Aaron X. Lee Vanderbilt University
  • Tatsuki Koyama Vanderbilt University
  • Noah Canvasser University of California Davis Medical Center, Sacramento
  • Naeem Bhojani University of Montreal
  • Ryan S. Hsi UC Irvine
  • Collaborative for Research in Endourology (CoRE)

DOI:

https://doi.org/10.5489/cuaj.9761

Keywords:

colic, endourology, lithotripsy, Nephrolithiasis, Health quality improvement, stent, stentless, ureteral stent, ureteroscopy, urolithiasis

Abstract

INTRODUCTION: Ureteral stent placement after ureteroscopy is a major contributor to patient morbidity. We sought to evaluate postoperative complications and quality of life (QoL) metrics comparing individuals receiving ureteral stent placement vs. stent omission after ureteroscopy.

METHODS: A multicenter, randomized controlled trial was performed among patients undergoing ureteroscopy and laser lithotripsy for non-obstructing renal stones with up to 1.5 cm in total stone diameter. Ureteral access sheath use and laser technique were at the discretion of the surgeon. At case end, if no ureteral injury was observed, patients were randomized to stent placement or stent omission. Primary outcome was the 30-day occurrence of emergency department visits, unanticipated provider visits, or hospitalization. Secondary outcomes included QoL measured by the Wisconsin Stone Quality of Life (WISQOL) and the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference surveys, opiate use, and abnormal imaging findings at followup.

RESULTS: Of 103 patients enrolled with mean (standard deviation [SD]) stone diameter 9.6 mm (4.5), 74 were randomized to stent placement (n=36) or stent omission (n=38). Ureteral access sheaths were used in 83% and 61% of patients in the stented and unstented groups, respectively. There was no difference in rate of 30-day complications between stent and stent omission cohorts (8% vs. 11%, absolute risk difference -2%, 95% confidence interval [CI] -15%, 11%, p=0.75). Stent omission showed better adjusted pre- vs. post-surgery WISQOL scaled score (16.7, 95% CI 3.1, 30.4, p=0.02) and PROMIS 6a t-score (-8.5, 95% CI -15.3, -1.6, p=0.02). No differences between groups were observed in the cumulative opiate use, ability to return to work, symptomatic urinary tract infection, or abnormal imaging findings at followup.

CONCLUSIONS: Compared to ureteral stent placement, stent omission after ureteroscopy for renal stones appears to be feasible and suggests improved short-term patient-reported outcomes in selected patients. This study was limited by small sample size, and future larger studies are needed.

Downloads

Download data is not yet available.

Downloads

Published

2026-05-29

How to Cite

Bechis, S. K., Wollin, D. A., Rivera, M., Ingimarsson, J., Scotland, K., Lee, A. X., … Collaborative for Research in Endourology (CoRE). (2026). Randomized, multicenter trial of ureteral stent placement vs. stent omission after ureteroscopy for renal stones. Canadian Urological Association Journal, 20(6), 200–7. https://doi.org/10.5489/cuaj.9761

Issue

Vol. 20 No. 6 (2026): CUAJ June

Section

Original Research

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.