title: Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones.
abstract: Ureteroscopic lithotripsy (URL) and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteral stones. The need for ureteral stenting during these procedures is controversial. In this meta-analysis, we evaluated the benefits and disadvantages of ureteral stents for the treatment of ureteral stones.
  
  
  
  Databases including PubMed, Embase and Cochrane library were selected for systematic review of randomized controlled trials (RCTs) comparing outcomes with or without stenting during URL and ESWL. Meta-analysis was performed using RevMan 5.3 and STATA 13.0 software.
  
  
  
  We identified 22 RCTs comparing stenting and non-stenting. The stented group was associated with longer operation time (WMD: 4.93; 95% CI: 2.07 to 7.84; p < 0.001), lower stone-free rate (OR: 0.55; 95% CI: 0.34 to 0.89; p = 0.01). In terms of complications, the incidence of hematuria (OR: 3.68; 95% CI: 1.86 to 7.29; p < 0.001), irritative urinary symptoms (OR: 4.40; 95% CI: 2.19 to 9.10; p < 0.001), urinary infection (OR: 2.23; 95% CI: 1.57 to 3.19; p < 0.001), and dysuria (OR: 3.90; 95% CI: 2.51 to 6.07; p < 0.001) were significantly higher in the stented group. No significant differences in visual analogue score (VAS), stricture formation, fever, or hospital stay were found between stenting and non-stenting groups. The risk of unplanned readmissions (OR: 0.63; 95% CI: 0.41 to 0.97; p = 0.04) was higher in the non-stented group.
  
  
  
  Our analysis showed that stenting failed to improve the stone-free rate, and instead, it resulted in additional complications. However, ureteral stents are valuable in preventing unplanned re-hospitalization. Additional randomized controlled trials are still required to corroborate our findings.
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Libo
authors.initials: L
authors.lastname: Man
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Guizhong
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Guanglin
authors.initials: G
authors.lastname: Huang
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Wang
mesh_terms: D003131:Combined Modality Therapy; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008096:Lithotripsy / Q000379:methods; D008297:Male; D016017:Odds Ratio; D010146:Pain / Q000209:etiology; D017594:Publication Bias; D015607:Stents; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D018666:Ureteroscopy / Q000379:methods; D014552:Urinary Tract Infections / Q000209:etiology