Ureteric stents are widely used throughout urological surgery, most commonly following ureteroscopic procedures (URS). This systematic review aims to assess the current evidence concerning stent on string (SOS) placed after ureteroscopy and compare it to stents without strings (SWOS).
A systematic review was conducted on several databases using the PRISMA methodology for studies in English language, for patients of all age groups, who had a SOS following URS for stone disease.
Of 1210 records identified, a total of 22 studies (20 adult and 2 paediatric studies) were included, with a total of 8382 patients. Of these, 3427 (40.9%) had SOS inserted and 434 (11%) were in the paediatric age group. Our results show that SOS provides several advantages and compared to SWOS, they were in situ for less time, with no difference in complications such as urinary tract infection or urinary symptoms. Further, significant cost savings, less pain on removal and high rates of safe home removal were reported in SOS, with over 90% patients reporting that they would be happy to remove their SOS at home. However, a small risk of stent dislodgement must be considered when making decisions regarding SOS placement following ureteroscopy.
SOS provides an excellent option following ureteroscopy, especially in those patients with no intraoperative complication, and their placement is done as a routine insertion based on surgeon preference. These stents reduce dwell time, pain, cost, risks and suffering involved from prolonged stenting and majority of patients are happy to remove it themselves at home. While their use seems to be still restricted in the current endourology practices, they are likely to become the new gold standard for routine ureteroscopy in future, with more shared decision making and patient reported outcome measures coming into the mainstream.
Journal of endourology. 2023 Dec 19 [Epub ahead of print]
Nick Harrison, Charlotte Hughes, Bhaskar K Somani
Mersey and West Lancashire Teaching Hospitals NHS Trust, Urology, Warrington, United Kingdom of Great Britain and Northern Ireland; ., Norfolk and Norwich University Hospitals NHS Foundation Trust, 6107, Urology, Norwich, Norfolk, United Kingdom of Great Britain and Northern Ireland; ., University Hospital Southampton NHS Foundation Trust, 7425, Urology, Southampton, United Kingdom of Great Britain and Northern Ireland; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38115630