Omitting catheterization after ureteroscopic lithotripsy: a prospective, multicenter, randomized controlled trial
In brief
Skipping catheter after ureteroscopic stone removal cuts urinary symptoms from 25% to 10%
In a multicenter randomized trial of 180 patients, omitting routine indwelling catheters after ureteroscopic lithotripsy lowered the rate of postoperative lower urinary tract symptoms to 9.9% versus 24.7% with a catheter, without increasing fever or retention. Patients also reported fewer distressing memories at one month, suggesting a safer, more comfortable postoperative approach.
- Journal
- World journal of urology (Q1)
- Published
- 16 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Ziyang Zheng, Ruixuan Zhu, Qi Zhang, Yan Zhuang, Anji Ren, Weiming Mou, et al.
- PMID
- 42461413
- DOI
- 10.1007/s00345-026-06605-9
Why clinicians should know about it
- Picked for Urology (top studies of the week, 11 October 2026): Multicenter RCT, omitting catheter after ureteroscopic lithotripsy
Abstract
PURPOSE: To determine whether omitting routine indwelling catheterization after ureteroscopic lithotripsy reduces postoperative lower urinary tract symptoms and enhances patient comfort, without compromising safety. METHODS: In this prospective, multicenter, randomized controlled trial, 180 patients undergoing ureteroscopic lithotripsy from August 2024 to June 2025 at four centers were allocated to either the No-Catheter group (n = 91) or the Catheter group (n = 89). The primary outcome was the incidence of lower urinary tract symptoms (LUTS) evaluated by the Patient Perception of Intensity of Urgency Scale and the Visual Analog Scale for pain at 1 h, 4 h, 1 day postoperatively. Secondary outcomes included complications (fever and urinary retention) and distressing memories assessed at a 1-month follow-up using the Subjective Units of Distress Scale. RESULTS: The No-Catheter group had significantly lower LUTS incidence at day 1 (9.9% vs. 24.7%, p = 0.012) and reduced urgency at 1 h and 4 h (p < 0.05). Fewer No-Catheter patients reported distressing LUTS memories at 1 month (7.7% vs. 25.8%, p < 0.001). Complication rates were comparable between groups (p > 0.05). CONCLUSION: Omitting routine indwelling catheterization after ureteroscopic lithotripsy appears to be 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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.