Ureteral stents are widely used following ureteroscopy (URS), yet several aspects of their management remain non-standardized despite contemporary EAU and AUA guideline recommendations. This study evaluated contemporary international practices and identified gaps in ureteral stent use among endourologists.
A cross-sectional international survey consisting of 58 items across nine domains was distributed via social media, major urological meetings, and the EAU Endourology Section. Only fully completed responses were analyzed. Descriptive statistics were used, with continuous variables reported as medians and categorical variables as frequencies and percentages.
A total of 121 respondents from 48 countries were included. Stent placement remained common after uncomplicated ureteroscopy and was nearly universal in complicated cases. Pre-stenting was applied selectively, most commonly after failed ureteroscopy and for ureteral dilatation. A 6 Fr stent and polyurethane material were the preferred choices. Stent-related symptoms were frequent, with urgency and frequency predominating, followed by hematuria. Pharmacologic management varied, and conservative treatment was commonly used for post-stenting infections. Notably, 45% of respondents did not use a structured stent-tracking system and 71.8% had never used a validated symptom-assessment tool such as the USSQ. Exploratory subgroup analyses identified differences according to geographic region, institution type, and endourological training background in selected aspects of stent management, including pre-stenting duration, long-term stent exchange protocols, pharmacologic management, and follow-up systems.
International ureteral stent practices show substantial variability. Although core practices were broadly comparable across regions, important gaps remain in stent tracking and symptom assessment, highlighting opportunities to improve patient safety and standardize care.
World journal of urology. 2026 Jul 19*** epublish ***
Burak Akgul, Selcuk Guven, Gernot Ortner, Hakan Akdere, Bhaskar Somani, Vineet Gauhar, Steffi Kar Kei Yuen, Panagiotis Kallidonis, Thomas Rw Herrmann, Udo Nagele, Theodoros Tokas
Department of Urology, School of Medicine, Indiana University, Indianapolis, IN, USA. ., Department of Urology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey., Department of Urology and Andrology, Hall in Tirol, General Hospital Hall I.T., Hall in Tirol, Austria., Department of Urology, School of Medicine, Trakya University, Edirne, Turkey., Department of Urology, University Hospital, Southampton NHS Trust, Southampton, UK., Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore., Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China., Department of Urology, University of Patras, Patras, Greece., Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland., Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.