title: Is stone diameter a variable in the decision process of employing a ureteral stent in patients undergoing uncomplicated ureterorenoscopy and associated intracorporeal lithotripsy?
abstract: BACKGROUND
  A number of randomized trials and meta-analysis in patients who underwent ureteroscopic stone removal investigated the effects of placing a ureteral stent at the end of the procedure on complication rates. However, none of these investigates the stone diameter and its possible influence on complication rates and, as such, if it should be considered a possible variable in the decision process of placing or not a ureteral stent.
  
  
  METHODS
  A bibliographic search covering the period from January 1990 to March 2012 was conducted in PubMed, MEDLINE and EMBASE. This analysis is based on the fifteen remaining studies which fulfilled the predefined inclusion criteria. All statistical evaluations were performed using SAS version 9.2. and by RevMan 5.0.
  
  
  RESULTS
  A total of 1,416 patients were included. All the studies were published after 2000. Mean stone diameter ranged between 5.3 and 13.3 mm in the non-stented group and between 6.26 and 13.28 mm in the stented group. Meta-analysis showed that stone diameter was not statistically different for stented or non-stented subgroups, whereas surgical operative time was shorter for the non-stented subgroup. The effect of stone diameter, irrespectively if patients were operated with or without stents were grouped or considered separately, did not influence complications of fever, haematuria, unplanned medical visits after surgery and urinary tract infections.
  
  
  CONCLUSIONS
  Stone diameter is not a variable in the pre- or intraoperative decision process of placing or not placing a ureteral stent in patients undergoing uncomplicated ureterorenoscopy with intracorporeal lithotripsy.
authors: Urology Department, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy, stepico@tin.it.
authors: Stefano C M
authors: SC
authors: Picozzi
authors: Cristian
authors: C
authors: Ricci
authors: Robert
authors: R
authors: Stubinski
authors: Stefano
authors: S
authors: Casellato
authors: Dario
authors: D
authors: Ratti
authors: Alberto
authors: A
authors: Macchi
authors: Giorgio
authors: G
authors: Bozzini
authors: Luca
authors: L
authors: Carmignani
mesh_terms: D003657:Decision Making; D006417:Hematuria / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D015607:Stents / Q000009:adverse effects / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000473:pathology* / Q000601:surgery*; D018666:Ureteroscopy / Q000295:instrumentation / Q000379:methods*