Evaluation of postoperative safety and comfort of ureteral stent removal with extraction string in modified split-leg prone percutaneous nephrolithotomy.

OBJECTIVE

To evaluate the safety and comfort of ureteral stents with extraction strings during modified split-leg prone percutaneous nephrolithotomy (PCNL).

METHODS

A prospective, single-centre study was conducted on 100 patients undergoing PCNL for unilateral upper urinary tract stones from April to August 2024. Patients were randomized into two groups: 50 with extraction-string stents and 50 without. Standardized surgical and postoperative protocols were followed. Primary outcomes included pain scores during stent removal, incidence of hematuria and flank pain, stent indwelling time, and cost analysis. Statistical analysis was performed using GraphPad Prism 9.5.0.

RESULTS

The extraction-string group demonstrated significantly lower pain scores during stent removal (0.86 ± 0.62 vs. 5.23 ± 1.74, p < 0.05) and shorter stent indwelling time (16.06 ± 4.48 vs. 60.54 ± 20.4 days, p < 0.05). The incidence of hematuria (8 vs. 29 cases) and flank pain (7 vs. 22 cases) was notably lower in the extraction-string group (p < 0.05). Additionally, each patient in this group saved an average of 1,065 Yuan (145.78 USD) by avoiding cystoscopic removal. No significant differences were observed in postoperative hospitalization days or urinary irritation symptoms (p > 0.05).

CONCLUSION

The use of extraction-string ureteral stents during modified split-leg prone PCNL significantly reduces stent removal pain, enhances procedural convenience, lowers economic burden, and maintains a safety profile comparable to traditional methods. This innovative technique represents a clinically valuable advancement in PCNL surgery.