To evaluate whether using flexible and navigable suction ureteral access sheath can obviate insertion of double J stent and establish the safety of overnight ureteric catheter placement as alternative following flexible ureteroscopy for kidney stones.
Five hundred forty adults were prospectively enrolled across 25 centers (from April 2023 to January 2024). Patients were divided into group 1 (overnight ureteric catheter), and group 2 (double J stent). Surgeons could choose either modality as per their discretion. One-to-one propensity score-matching for age, sex, pre-stenting, Hounsfield units, stone volume and location was performed. Thirty-day computed tomography scan was done to estimate stone-free status.
After matching, 120 patients were included in each group. Group 1 had significantly shorter lasing, ureteroscopy, surgical time. Median day 1 loin pain score was similar (1 [1, 2] in both groups). Median postoperative stay was shorter in group 1 (0 days [0, 1] vs. 1 day [0, 2], p<0.001). One patient in group 2 required a blood transfusion. Incidence of fever was similar (5.0% vs. 0.8%). Loin/abdominal pain requiring medication occurred in one patient in group 2. Stent-related symptoms occurred in 2 patients in group 1. Three patients (2.5%) in group 1 and 2 patients (1.7%) in group 2 required readmission. Thirty-day stone-free status was higher in group 1 patients (79.2% vs. 56.7%).
In selected patients after thorough inspection to ensure no injury or residual fragments remain, placing an overnight ureteric catheter can be a safe alternative to a double J stent.
Investigative and clinical urology. 2025 May [Epub]
Daniele Castellani, Bhaskar Kumar Somani, Khi Yung Fong, Steffi Kar Kei Yuen, Chin Tiong Heng, Mohamed Elshazly, Karl Tan, Thomas R W Herrmann, Olivier Traxer, Vineet Gauhar
Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy., European Association of Urology Section of Endourology, Arnhem, The Netherlands., Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Department of Urology, Ng Teng Fong General Hospital, Singapore., Urology Unit, Menoufia University, Shibin el Kom, Egypt., Department of Surgery, Section of Urology, Veterans Memorial Medical Center, Quezon City, Philippines.