Abstract: PD16-07
Sources of Funding: Watts Family Fellowship in Urology within the Department of Urology at the University of Iowa

Introduction

Many urologists elect to place a stent following ureteroscopy for nephrolithiasis, but little data exists on the optimal duration to leave a stent. Indwelling stents are associated a number of undesirable symptoms. We sought to determine whether there are any differences in postoperative outcomes for patients with a 3-day versus 7-day stent following ureteroscopy for nephrolithiasis.

Methods

Following Institutional Review Board approval, we retrospectively reviewed 247 patients who underwent unilateral ureteroscopy with lithotripsy from 2010-2016. 79 of these patients removed a stent with an extraction string at either 3 or 7 days post-operatively. The transition from 7-day to 3-day stenting occurred in May 2014. These two groups were compared with regard to demographic information, pre-operative variables, and post-operative outcomes.

Results

33% of all patients experienced a post-procedure related event (phone call, extra clinic visit, emergency department visit) within 30 days of their procedure, 39% of 3-day stent patients compared to 21% of 7-day patients (p=0.11). Within the 3 days following stent removal, 3-day stent patients were significantly more likely to have a post-procedure related event than 7-day patients (23% vs 3%, p=0.026). There was a trend towards more frequently reported flank pain in 3-day patients (33% vs 14%, p=0.075). There was no difference between the groups in clinically insignificant stone fragments, post-operative hydronephrosis, or hospital readmissions. _x000D_

Conclusions

One third of patients with a post-operative ureteral stent will seek additional medical care in the 30 days following ureteroscopy. It does not appear that leaving a stent for 3-days versus 7-days results in improved outcomes and may, in fact, lead to worse outcomes with regard to post-operative events and flank pain, particularly in the 3 days following stent removal. This pilot study provides a framework for future prospective analyses of appropriate stent duration in this population of patients.

Funding

Watts Family Fellowship in Urology within the Department of Urology at the University of Iowa