One day ureteral catheter placement after ureteroscopic lithotripsy: A prospective study

Introduction and Objective: We evaluated the efficacy and safety of 1 day ureteral catheter placement after ureteroscopic lithotripsy in non-complicated surgery and compared with long term ureteral stenting. Materials and Methods: A total of 54 patients who underwent ureteroscopic lithotripsy for ureteral stone from February 2009 to October 2010 were randomly divided into 2 groups. Group I patients (n=26) had a 5Fr. open tip ureteral catheter placed after ureteroscopic lithotripsy and removed the catheter at postoperative day 1. These patients were discharged from hospital at postoperative day 2 and they were kept under observation for the occurrence of flank pain. Group II patients (n=28) had a double J stent placed after ureteroscopic lithotripsy and removed the double J stent at postoperative day 14 using cystoscopy under local anesthesia. The inclusion criteria were less than 10mm of stone size, absence of ureteral injury during surgery and absence of ureteral wall edema. For quantification of pain, all the patients filled in the visual analogue pain scale (VAP) at postoperative day 1 and 7 and the patients with double J stent were filled in the VAP immediately after cystoscopy. Results: Lithotripsies were performed with 5/6.5 Fr and 8/9.5Fr ureteroscope. Age, the size of ureter stone and the operative time were not different between two groups. The VAP score was not different at postoperative day 1, but there were different at postoperative day 7 between group I and group II, 0.30±0.55 and 2.82±1.25, respectively (p=0.01). The mean VAP score immediately after the cystoscopy for removal of double J stent was 4.96 in group 2 patients. Four patients in group I and 5 patients in group II were needed the intravenous analgesics because of colicky flank pain at postoperative day 1. There was no occurrence of the colicky pain after postoperative day 2 in both groups. Conclusions: The pain at postoperative day 1 and the incidence of colicky pain were not different between the two groups but the flank pain in group I at postoperative day 7 was significantly smaller. We think one day ureteral catheter placement after ureteroscopic lithotripsy could be an optional procedure in patients who are undergoing uncomplicated ureteroscopic lithotripsy.