Morbidity Associated with Ureteral Stents Placed Prior to Extracorporeal Shock Wave Lithotripsy

Abstract

A retrospective review was undertaken, assessing the outcome of extracorporeal shock wave lithotripsy (ESWL*) for patients with renal calculi, smaller than 3 cm, treated in a large, multi-user lithotripsy center.

Patients who had indwelling ureteral stents placed prior to lithotripsy treatment were subjected to higher levels of total power (number of shock waves times voltage), yet their stone-free rate did not differ from those patients treated without prior placement of a stent. In addition, the patients with stents experienced a significantly higher incidence of bladder discomfort and urinary urgency than did patients without stents. In addition, the duration of bladder discomfort was longer for patients with stents, as was the duration of urinary frequency compared to patients without stents.

The results suggest that the use of an indwelling ureteral stent when performing ESWL may not contribute to a higher stone-free rate for the treatment of small-to-medium sized renal calculi and, in fact, may make the treatment more uncomfortable for the patient than it would be if lithotripsy were performed without the use of a ureteral stent. In selected cases (patients with a solitary kidney or a large stone burden and as an aid to stone localization) ureteral stents play a useful adjunctive role to ESWL.