Comprehensive survey on urological stent practices by the European Association of Urology (EAU) Endourology.

purposeUreteral stents are widely used following ureteroscopy (URS), yet several aspects of their management remain non-standardized despite contemporary EAU and AUA guideline recommendations. This study evaluated contemporary international practices and identified gaps in ureteral stent use among endourologists.

methodsA cross-sectional international survey consisting of 58 items across nine domains was distributed via social media, major urological meetings, and the EAU Endourology Section. Only fully completed responses were analyzed. Descriptive statistics were used, with continuous variables reported as medians and categorical variables as frequencies and percentages.

resultsA total of 121 respondents from 48 countries were included. Stent placement remained common after uncomplicated ureteroscopy and was nearly universal in complicated cases. Pre-stenting was applied selectively, most commonly after failed ureteroscopy and for ureteral dilatation. A 6 Fr stent and polyurethane material were the preferred choices. Stent-related symptoms were frequent, with urgency and frequency predominating, followed by hematuria. Pharmacologic management varied, and conservative treatment was commonly used for post-stenting infections. Notably, 45% of respondents did not use a structured stent-tracking system and 71.8% had never used a validated symptom-assessment tool such as the USSQ. Exploratory subgroup analyses identified differences according to geographic region, institution type, and endourological training background in selected aspects of stent management, including pre-stenting duration, long-term stent exchange protocols, pharmacologic management, and follow-up systems.

conclusionInternational ureteral stent practices show substantial variability. Although core practices were broadly comparable across regions, important gaps remain in stent tracking and symptom assessment, highlighting opportunities to improve patient safety and standardize care.