title: Is ureteral stenting really necessary after ureteroscopic lithotripsy with balloon dilatation of ureteral orifice? A multi-institutional randomized controlled study.
abstract: OBJECTIVE
  Our aim was to evaluate the role of balloon dilatation of the ureteral orifice on the decision to stent after ureteroscopy.
  
  
  METHODS
  We prospectively enrolled 505 patients from two clinics, undergoing ureteroscopy (URS) for urolithiasis. Patients having balloon dilatation of the ureteral orifice and uncomplicated ureteroscopy were randomized to be either stented (n = 144) or nonstented (n = 142). Ureteroscopy was done with a 9.8 rigid ureteroscope. For dilatation of ureteral orifice, 18Fr-4 cm balloons were used (Uromax™, Boston Scientific, USA). Holmium laser or pneumatic devices were used for lithotripsy. In the second postoperative week, patients were asked to assess: pain, dysuria, and urgency using a 10-cm visual analog score (VAS) and unplanned visits. In each visit, urinalysis, urine culture, plain X-ray, and ultrasound examinations were performed. Six months after URS, follow-up IVU was performed to evaluate ureteral narrowing. Results for the separate clinics were not revealed until the end of study.
  
  
  RESULTS
  There were no significant differences between the two groups regarding gender, age, preoperative serum creatinine levels, stone size, stone side and location, lithotripsy type, pain, infectious complications, unplanned visits, and ureteral narrowing. However, irritative symptoms were more common in the stented group. Success rates of 97.8 and 97.2% were similar in the unstented and stented groups.
  
  
  CONCLUSIONS
  In uncomplicated URS, balloon dilatation of the ureteral orifice should not significantly affect the decision for or against stent placement. Avoiding stents lowers costs and gives fewer irritative symptoms.
authors: ESOGU Medical Faculty Urology Department, Meselik, Eskişehir, Turkey. barbaroza@gmail.com
authors: Barbaros
authors: B
authors: Başeskioğlu
authors: Mustafa
authors: M
authors: Sofikerim
authors: Abdullah
authors: A
authors: Demirtaş
authors: Aydın
authors: A
authors: Yenilmez
authors: Coşkun
authors: C
authors: Kaya
authors: Cavit
authors: C
authors: Can
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