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Meta-analysis of postoperatively stenting or not in patients underwent ureteroscopic lithotripsy

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Abstract

The aim of this study was to evaluate the necessity for stenting after ureteroscopic lithotripsy. We performed a systematic research of Medline, Embase, Cochrane central registration for RCTs concerning the comparison between stented and non-stented post-ureteroscopic procedures for stone removal and reference lists of the included study were also screened. 15 trials were included and data related was extracted and analyzed in meta way. No difference was detected in stone free rate and stricture formation between the two groups (P = 0.69; P = 0.67). Participants with stents had higher risk of being infected than those without, RR = 1.72, but with no difference. Stent related lower urinary symptoms were more frequently experienced by stented patients, dysuria (RR = 5.24, P = 0.003); hematuria (RR = 7.28, P = 0.001); loin voiding pain (RR = 5.24, P = 0.003). Postoperative pain score were also higher in patients with stent in the early period after surgery with mean difference 0.95 (P = 0.002). With additional time needed for the placement of stent, the operative time in stented patients were 3.36 min longer than those without stenting (P = 0.02). The additional cost for longer operative room stay, together with the sent and cystoscopic stent removed conditionally, and made the cost for stented patients much higher. No difference were detected in length of hospital stay between both groups (P = 0.22), the stented patients were even of lower rate pay unplanned hospital visit (RR = 0.81, P = 0.55). Stenting did not improve the outcome of patients who underwent ureteroscopic lithotripsy, but associated with increased complication rate. Routinely stenting after ureteroscopic procedure for stone removal was not necessary; however, it still should be reserved conditionally.

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Acknowledgments

The authors express appreciation to Dr. Jin Chen for the support on technical aspects of this study.

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Authors and Affiliations

  1. Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu, 610041, Sichuan, People’s Republic of China

    Turun Song, Banghua Liao, Shuo Zheng & Qiang Wei

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  1. Turun Song
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  2. Banghua Liao
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  3. Shuo Zheng
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  4. Qiang Wei
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Corresponding author

Correspondence to Qiang Wei.

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Banghua Liao is the Co-author of Turun Song.

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Song, T., Liao, B., Zheng, S. et al. Meta-analysis of postoperatively stenting or not in patients underwent ureteroscopic lithotripsy. Urol Res 40, 67–77 (2012). https://doi.org/10.1007/s00240-011-0385-7

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  • DOI: https://doi.org/10.1007/s00240-011-0385-7

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