Stent is a bane for urologists.

PURPOSE : To argue that routine ureteral stent placement after uncomplicated ureteroscopy constitutes an overused practice that imposes significant and often unnecessary morbidity on patients, and to advocate for selective, evidence-based stenting.

METHODS

A narrative review of current literature was performed, examining evidence on stent-related symptoms, infectious complications, biofilm formation, forgotten stent sequelae, practice variation data, economic burden, and medicolegal consequences of routine ureteral stenting after ureteroscopy.

RESULTS

Evidence demonstrates that 78–80% of stented patients experience bothersome lower urinary tract symptoms, with over 80% reporting significant pain affecting daily activities. Stent biofilm formation occurs almost invariably within 1–2 weeks, and preoperative stent dwell time exceeding two months is associated with a nearly 4-fold increased risk of febrile urinary tract infection. Forgotten stents occur in up to 12% of cases and represent the single largest source of successful negligence claims in urology. Despite guideline recommendations, stenting rates persist at approximately 80%, with individual surgeon rates ranging from less than 10% to nearly 100%. The economic burden includes additional removal procedures, emergency department visits, and substantial patient productivity losses, with 58% of stented patients reporting reduced work capacity.

CONCLUSION

Routine ureteral stenting after uncomplicated ureteroscopy subjects the majority of patients to preventable morbidity with no consistent evidence of benefit. A paradigm shift toward selective, evidence-based stent placement is warranted. For appropriately selected low-risk patients, the safest stent is no stent at all.