Krushnadevsinh JADEJA, Kshitij RAGHUVANSHI, Rajeev CHOUDHARY
Journal of Urological Surgery - 2026;13(3):207-211
Objective: Retrograde intrarenal surgery (RIRS) is an established treatment modality for renal calculi <=2 cm. Preoperative ureteral stenting is often employed to facilitate access, but its influence on residual fragment rates remains controversial. This prospective study aimed to evaluate the impact of ureteral pre-stenting on residual stone fragments following RIRS. Materials and Methods: A prospective observational study was conducted at a tertiary care center from July 2023 to December 2024, involving 180 patients with renal calculi. Participants were randomized into two groups: pre-stented (n=90) and non-stented (n=90). All patients underwent RIRS according to standardized protocols and had a non-contrast computed tomography kidney, ureter, and bladder on postoperative day 90. Residual fragments >=3 mm were considered significant. Baseline demographics, stone parameters, intraoperative data, and postoperative outcomes were analyzed. Statistical significance was set at p<0.05. Results: Baseline characteristics, including age, body mass index, stone size, volume, and density, were comparable between groups. Ureteric access sheath (UAS) insertion was significantly more successful in the pre-stented group (100%) than in the non-stented group (86.66%, p=0.037). The mean operative time was shorter in the pre-stented group (79.70+/-18.83 min vs. 89.33+/-16.02 min, p=0.036). However, the residual fragment rate was identical in both groups (2 patients per group, 6.6%, p=1.000). Postoperative complications, including fever and urinary tract infection, did not differ significantly. Conclusion: Preoperative ureteral stenting improved the success of UAS insertion and reduced operative time during RIRS but did not influence the rate of residual stone fragments. Pre-stenting may be beneficial in optimizing surgical access, but does not appear to directly enhance stone clearance outcomes.
