Necessity Of Placement Of Ureteral Stents After Uncomplicated Ureteroscopy Lithotripsy For Ureteral Calculi:A Meta-analysis

Objective: The aim of this study was to evaluate the necessity for stenting after uncomplicated ureteroscopic lithotripsy.Method: A systematic search of CBM,CNKI,VIP,WANFANG datebase,PubMed,Embase and the Cochrane Library was performed to identify all randomized controlled trials.All relevant studies were on the outcomes and complications of ureteroscopic lithotripsy in the management of ureteral stones with or without a ureteral stent.The outcomes assesed include operative time,postoperative stone-free rate,lower urinary tract symptoms(dysuria,urinaryfrequency,hematuria),rehospitalization rate(unplanned medical visits),urinary tract infection.The Cochrane Collaboration Review Manager software(RevMan 5.2)was used for meta-analysis.Results: A total of 17 randomized controlled trials were enrolled for analysis and involved 1323 patients.The result of Meta-analysis show thatafter uncomplicated ureteroscopy lithotripsy,There was a statistically significant difference in Mean Operative Time(WMD = 3.61,95% CI : 1.45 ~ 5.76,P = 0.001),Dysuria rate(RR = 2.21,95% CI : 1.38 ~ 3.53,P = 0.0009),Urinary frequence rate(RR = 1.54,95% CI : 1.06 ~ 2.23,P = 0.002),Hematuria rate(RR= 1.85,95% CI : 1.17 ~ 2.90,P = 0.008),rehospitalization rate(RR = 0.42,95% CI : 0.23 ~ 0.78,P = 0.006)between the twogroups,There was no statistically significant difference in stone-free rate(RR = 0.98,95% CI : 0.96 ~ 1.00,P =0.09)and Urinary tract infections(RR = 0.32,95% CI : 0.06 ~ 1.62,P = 0.17).Conclusions: This meta-analysis reveals that Ureteral stenting after un-complicated ureteroscopic lithotripsy could be unnecessary.Without indwelling Stents do not improve stonefree rate,urinary infections rate but can reduce mean operative time,dysuria rate,urinary frequence rate,hematuria rate,rehospitalization between the two groups.