TOPLINE

Patients who did not receive a routine catheter after ureteroscopic lithotripsy showed a reduced incidence of lower urinary tract symptoms after surgery than those who had a catheter placed.

METHODOLOGY

• Researchers conducted a prospective randomized trial at four academic centers in China to determine the effect of omitting routine catheters after ureteroscopic lithotripsy.
• They enrolled 180 adult patients between 2024 and 2025 with upper urinary tract stones and normal kidney function who had a negative urine culture before surgery.
• Participants were randomly assigned to the catheter group (n = 89; mean age, 51.5 years; 76.4% men), in which a 16-F Foley catheter was placed post-surgery and removed approximately 1 day later, or to the no-catheter group (n = 91; mean age, 47.9 years; 71.4% men).
• Surgeons performed the procedure using a holmium:yttrium-aluminum-garnet laser, and a ureteral stent was placed in all patients after surgery.
• The primary outcome was the incidence of lower urinary tract symptoms, defined as the presence of urinary urgency and pain, assessed at 1 hour, 4 hours, and 1 day after surgery; secondary outcomes were safety and long-term patient experience.

TAKEAWAY

• At 1 hour after surgery, the overall rate of lower urinary tract symptoms was not significantly different between the catheter and no-catheter groups; however, more patients in the no-catheter group were free of urinary urgency at 1 hour and 4 hours after surgery than those in the catheter group (P < .05 for both).
• One day after surgery, the incidence of lower urinary tract symptoms was lower in the no-catheter group than in the catheter group (9.9% vs 24.7%; P = .012). Patients in the no-catheter group experienced reductions in pain (6.6% vs 20.2%; P = .008) and urinary urgency (13.2% vs 28.1%; P = .013).
• Rates of safety outcomes (postoperative fever and urinary retention) were similar between groups, with one case of each outcome occurring in the catheter group.

IN PRACTICE

“Omitting routine indwelling catheterization after ureteroscopic lithotripsy is a safe strategy that significantly reduces postoperative lower urinary tract symptoms and improves the patient experience. These findings support a change in clinical practice away from routine catheterization,” the researchers wrote.

SOURCE

The study was led by Ziyang Zheng of the Department of Urology in the Shanghai General Hospital at Shanghai Jiao Tong University School of Medicine in Shanghai, China. It was published online on July 16, 2026, in the World Journal of Urology.

LIMITATIONS

The study enrolled a carefully selected group of patients. The results did not clarify which higher-risk patients might still require catheterization.

DISCLOSURES

The study received financial support from the Shanghai Municipal Hospital Development Center Foundation and the Fundamental Research Funds for the Central Universities. The authors declared no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.