Preoperative double-J stent placement can improve the stone-free rate for patients undergoing ureteroscopic lithotripsy: a systematic review and meta-analysis.

To evaluate the efficiency and safety of preoperative double-J stent placement for patients undergoing ureteroscopic lithotripsy. Eligible studies were identified from electronic databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews). All analyses were performed by the Review Manager 5.3 (The Cochrane Collaboration, Oxford, UK). Stone-free rate (SFR) was regarded as primary outcome. Second outcomes, including operation time, complication rates as well as major complication rates were also assessed. A total of 11,239 patients (2605 with and 8634 without preoperative stent) from nine retrospective studies were included. Our pooled analysis showed that SFR was significantly higher in patients with a preoperative stent than those without a stent (OR 1.60, 95% CI 1.19-2.15, p = 0.002). Operation time was not significantly different between stented and non-stented groups (OR - 0.89, 95% CI - 5.79-4.01, p = 0.72). No significant differences of complication rates were observed between stented and non-stented groups (OR 0.94, 95% CI 0.67-1.33, p = 0.73). Furthermore, major complication rates were not significantly different between two groups, either (OR 1.07, 95% CI 0.43-2.70, p = 0.88). Generally, preoperative double-J stent placement significantly improved SFR of patients undergoing ureteroscopic lithotripsy. Operation time, complication rates, as well as major complication rates, were similar between stented and non-stented groups. However, the effect of preoperative double-J stent placement for different locations and burden of stones is unclear, more high-quality studies should be anticipated.