Stent Omission After Ureteroscopy and Lithotripsy in the Michigan Urological Surgery Improvement Collaborative

This study examines whether leaving out a ureteral stent after ureteroscopy and lithotripsy — a common procedure to remove kidney or ureter stones using a scope and laser — results in comparable recovery with less discomfort compared to routine stent placement. Ureteral stents are thin tubes placed inside the ureter after stone procedures to prevent blockage while the ureter heals, but they cause significant pain, urinary urgency, and reduced quality of life in many patients, and require a second procedure to remove. Adults undergoing ureteroscopy for kidney or ureter stones that are 10mm or smaller, with no pre-existing ureteral stents, normal urinary tract anatomy, and access to communication with the research team are eligible. Patients planning bilateral procedures, those with anatomic urinary abnormalities, a solitary kidney, planned staged procedures, or those taking daily opioids for pain are excluded. Participants are enrolled intraoperatively if the procedure goes smoothly, then randomized to stent omission or standard stenting, and followed up for pain, urinary symptoms, and complications. This research is significant because kidney stones affect roughly 10% of the population over a lifetime, ureteroscopy is among the most commonly performed urological procedures, and reducing stent use in appropriate patients could improve the experience of recovery for hundreds of thousands of patients annually.