From the Research
The optimal time for ureteral stent removal after lithotripsy is typically 3-7 days post-procedure, as supported by the most recent and highest quality study 1. This study demonstrated that patients with stent removal at 3 days had better reported urinary, pain, and general health scores compared to those with stent removal at 7 days. The decision to remove the stent should be based on individual circumstances, taking into account the complexity of the procedure, stone burden, degree of ureteral edema, and patient-specific factors such as kidney function and risk of obstruction. Some studies suggest that stenting duration of at least 5 days may be recommended to decrease adverse events and require less antibiotic use 2. However, the study by 1 provides the most recent and highest quality evidence, suggesting that a shorter duration of stent placement may be beneficial for patients. Key factors to consider when determining the optimal time for stent removal include:
- Complexity of the procedure
- Stone burden
- Degree of ureteral edema
- Patient-specific factors such as kidney function and risk of obstruction
- Presence of symptoms like flank pain, fever, or hematuria that may indicate complications requiring earlier stent removal. Stent removal is typically performed as an outpatient procedure using cystoscopy under local anesthesia, and patients should be advised to maintain adequate hydration while the stent is in place to help prevent encrustation and minimize discomfort. It is also important to note that the use of ureteral stents with extraction strings may allow for self-removal by patients, and the timing of stent removal may vary depending on the specific circumstances of the case. Overall, the optimal time for ureteral stent removal after lithotripsy should be determined on a case-by-case basis, taking into account the individual patient's needs and circumstances, and based on the most recent and highest quality evidence available 1.