Stent use with extracorporeal shock wave lithotripsy.

Since the advantages of using ureteral stents in conjunction with extracorporeal shock wave lithotripsy were first recognized, the growing demand for outpatient stone treatment has made stent use much more frequent. However, prophylactic stent placement must be judicious to maximize success and minimize associated morbidity. Recent controlled retrospective studies and randomized trials showed that ureteral stenting does not increase the stone-free rate or reduce the complication rate for stones less than 2 cm in size, yet in such cases, there are increased morbidities such as urinary urgency, frequency, stent migration, and encrustation. However, in patients with stones larger than 2 cm, Type C4 staghorn calculi, or stones associated with a solitary kidney, prophylactic stent placement may reduce the complication rates arising from these larger stone burdens. Finally, ureteral stenting may be helpful for stone localization or manipulation.