{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:40:55Z","timestamp":1790707255308,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Ureteral stent insertion passively dilates the ureter. Therefore, it is sometimes used preoperatively before flexible ureterorenoscopy to make the ureter more accessible and facilitate urolithiasis passage, especially when ureteroscopic access has failed or when the ureter is expected to be tight. However, it may cause stent-related discomfort and complications. This study aimed to assess the effect of ureteral stenting prior to retrograde intrarenal surgery (RIRS). Materials and Methods: Data from patients who underwent unilateral RIRS for renal stone with the use of a ureteral access sheath from January 2016 to May 2019 were retrospectively analyzed. Patient characteristics, including age, sex, BMI, presence of hydronephrosis, and treated side, were recorded. Stone characteristics in terms of maximal stone length, modified Seoul National University Renal Stone Complexity score, and stone composition were evaluated. Surgical outcomes, including operative time, complication rate, and stone-free rate, were compared between two groups divided by whether preoperative stenting was performed. Results: Of the 260 patients enrolled in this study, 106 patients had no preoperative stenting (stentless group), and 154 patients had stenting (stenting group). Patient characteristics except for the presence of hydronephrosis and stone composition were not statistically different between the two groups. In surgical outcomes, the stone-free rate was not statistically different between the two groups (p = 0.901); however, the operation time for the stenting group was longer than that of the stentless group (44.8 \u00b1 24.2 vs. 36.1 \u00b1 17.6 min; p = 0.001). There were no differences in the complication rate between the two groups (p = 0.523). Conclusions: Among surgical outcomes for RIRS with a ureteral access sheath, preoperative ureteral stenting does not provide a significant advantage over non-stenting with respect to the stone-free rate and complication rate.<\/jats:p>","DOI":"10.3390\/medicina59040744","type":"journal-article","created":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T02:02:33Z","timestamp":1681178553000},"page":"744","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of Preoperative Ureteral Stenting in Retrograde Intrarenal Surgery for Urolithiasis"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8577-3920","authenticated-orcid":false,"given":"Jae Yong","family":"Jeong","sequence":"first","affiliation":[{"name":"Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang 10444, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3500-8833","authenticated-orcid":false,"given":"Kang Su","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7928-5659","authenticated-orcid":false,"given":"Dae Young","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Joon","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Urology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu 41944, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0814-7336","authenticated-orcid":false,"given":"Dong Hyuk","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Urology, Inha University College of Medicine, Incheon 22332, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8287-585X","authenticated-orcid":false,"given":"Hae Do","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3470-1767","authenticated-orcid":false,"given":"Joo Yong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea"},{"name":"Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.ucl.2018.12.013","article-title":"Innovations in ureteral stent technology","volume":"46","author":"Forbes","year":"2019","journal-title":"Urol. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/MOU.0000000000001003","article-title":"Advances in ureteral stent technology","volume":"32","author":"Mawhorter","year":"2022","journal-title":"Curr. Opin. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.3349\/ymj.2022.0367","article-title":"In vivo feasibility test of a new flexible ureteroscopic robotic system, easyuretero, for renal stone retrieval in a porcine model","volume":"63","author":"Kim","year":"2022","journal-title":"Yonsei. Med. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"440","DOI":"10.3349\/ymj.2022.63.5.440","article-title":"The first 100 cases of endoscopic combined intrarenal surgery in korea: Matched cohort analyses versus shock-wave lithotripsy","volume":"63","author":"Jung","year":"2022","journal-title":"Yonsei. Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4111\/icu.20200526","article-title":"Retrograde intrarenal surgery: Past, present, and future","volume":"62","author":"Inoue","year":"2021","journal-title":"Investig. Clin. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"433","DOI":"10.4111\/icu.20220081","article-title":"Different failure rates of insertion of 10\/12-fr ureteral access sheaths during retrograde intrarenal surgery in patients with and without stones","volume":"63","author":"Waseda","year":"2022","journal-title":"Investig. Clin. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1089\/end.2012.0414","article-title":"Ureteral stents for impassable ureteroscopy","volume":"27","author":"Ambani","year":"2013","journal-title":"J. Endourol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1111\/j.1464-410X.2008.08184.x","article-title":"Pilot study evaluating ureteric physiological changes with a novel \u2018ribbon stent\u2019 design using electromyographic and giant magnetoresistive sensors","volume":"103","author":"Natalin","year":"2009","journal-title":"BJU Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1089\/end.2009.0361","article-title":"Evidence-based drainage of infected hydronephrosis secondary to ureteric calculi","volume":"24","author":"Ramsey","year":"2010","journal-title":"J. Endourol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1089\/end.2010.0554","article-title":"Randomized prospective trial comparing immediate versus delayed ureteroscopy for patients with ureteral calculi and normal renal function who present to the emergency department","volume":"25","author":"Guercio","year":"2011","journal-title":"J. Endourol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1089\/end.2007.9888","article-title":"Prestenting improves ureteroscopic stone-free rates","volume":"21","author":"Rubenstein","year":"2007","journal-title":"J. Endourol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s00345-011-0789-6","article-title":"Impact of ureteral stenting prior to ureterorenoscopy on stone-free rates and complications","volume":"31","author":"Lumma","year":"2013","journal-title":"World J. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1016\/j.urology.2012.06.064","article-title":"Impact of preoperative ureteral stenting on stone-free rates of ureteroscopy for nephroureterolithiasis: A matched-paired analysis of 286 patients","volume":"80","author":"Netsch","year":"2012","journal-title":"Urology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2768","DOI":"10.1016\/j.juro.2009.08.043","article-title":"Impact of preoperative ureteral stenting on outcome of ureteroscopic treatment for urinary lithiasis","volume":"182","author":"Shields","year":"2009","journal-title":"J. Urol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1089\/end.2010.0400","article-title":"Preoperative stenting decreases operative time and reoperative rates of ureteroscopy","volume":"25","author":"Chu","year":"2011","journal-title":"J. Endourol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1111\/j.1442-2042.2012.03046.x","article-title":"Preoperative stenting for ureteroscopic lithotripsy for a large renal stone","volume":"19","author":"Kawahara","year":"2012","journal-title":"Int. J. Urol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.eururo.2015.07.041","article-title":"Eau guidelines on interventional treatment for urolithiasis","volume":"69","author":"Sarica","year":"2016","journal-title":"Eur. Urol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s00240-014-0650-7","article-title":"Modified seoul national university renal stone complexity score for retrograde intrarenal surgery","volume":"42","author":"Jung","year":"2014","journal-title":"Urolithiasis"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Jeong, J.Y., Cho, K.S., Kim, D.H., Jun, D.Y., Moon, Y.J., and Lee, J.Y. (2023). A new parameter for calcium oxalate stones: Impact of linear calculus density on non-contrast computed tomography. Medicina, 59.","DOI":"10.3390\/medicina59020267"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"462","DOI":"10.4111\/icu.20210039","article-title":"Large database study of urinary stone composition in south korea: Korean society of endourology and robotics (kser) research series","volume":"62","author":"Jung","year":"2021","journal-title":"Investig Clin. Urol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.euf.2017.02.014","article-title":"Validation of the clavien-dindo grading system in urology by the european association of urology guidelines ad hoc panel","volume":"4","author":"Mitropoulos","year":"2018","journal-title":"Eur. Urol. Focus"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2373","DOI":"10.1007\/s11517-022-02620-1","article-title":"Computational simulation of the flow dynamic field in a porous ureteric stent","volume":"60","author":"Yang","year":"2022","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s00240-002-0258-1","article-title":"Impact on ureteral peristalsis in a stented ureter. An experimental study in the pig","volume":"30","author":"Kinn","year":"2002","journal-title":"Urol. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"026102","DOI":"10.1063\/5.0083260","article-title":"The accumulation of particles in ureteric stents is mediated by flow dynamics: Full-scale computational and experimental modeling of the occluded and unoccluded ureter","volume":"6","author":"Mosayyebi","year":"2022","journal-title":"APL Bioeng"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1007\/s00345-022-03935-2","article-title":"Role of pre-operative ureteral stent on outcomes of retrograde intra-renal surgery (rirs): Systematic review and meta-analysis of 3831 patients and comparison of asian and non-asian cohorts","volume":"40","author":"Law","year":"2022","journal-title":"World J. Urol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/bju.13250","article-title":"Preoperative jj stent placement in ureteric and renal stone treatment: Results from the clinical research office of endourological society (croes) ureteroscopy (urs) global study","volume":"117","author":"Assimos","year":"2016","journal-title":"BJU Int."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Jun, D.Y., Cho, K.S., Jeong, J.Y., Moon, Y.J., Kang, D.H., Jung, H.D., and Lee, J.Y. (2022). Comparison of surgical outcomes between single-use and reusable flexible ureteroscopes for renal stone management: A systematic review and meta-analysis. Medicina, 58.","DOI":"10.3390\/medicina58101388"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e2728","DOI":"10.7717\/peerj.2728","article-title":"Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis","volume":"4","author":"Zhang","year":"2016","journal-title":"PeerJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1111\/bju.12775","article-title":"Development and internal validation of a nomogram for predicting stone-free status after flexible ureteroscopy for renal stones","volume":"115","author":"Ito","year":"2015","journal-title":"BJU Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s11934-018-0818-8","article-title":"Ureteral stent discomfort and its management","volume":"19","author":"Fischer","year":"2018","journal-title":"Curr. Urol. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1080\/08927014.2018.1562549","article-title":"Ureteral stent-associated infection and sepsis: Pathogenesis and prevention: A review","volume":"35","author":"Scotland","year":"2019","journal-title":"Biofouling"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/s11934-020-0969-2","article-title":"Predictors of urinary infections and urosepsis after ureteroscopy for stone disease: A systematic review from eau section of urolithiasis (eulis)","volume":"21","author":"Chugh","year":"2020","journal-title":"Curr. Urol. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1089\/end.2016.0304","article-title":"Defining the rate of primary ureteroscopic failure in unstented patients: A multi-institutional study","volume":"30","author":"Fuller","year":"2016","journal-title":"J. Endourol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/744\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:13:29Z","timestamp":1760123609000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,10]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["medicina59040744"],"URL":"https:\/\/doi.org\/10.3390\/medicina59040744","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,10]]}}}