Is stent on a string (SOS) the new gold standard for post-ureteroscopy ureteric drainage? Evidence from a systematic review.

Published Date: 01st June 2025

Publication Authors: Harrison. N, Hughes. C, Soman. B

Conference Abstract:
Introduction: Ureteric stents are widely used throughout urological surgery, however concern over their side effects has prompted the development of alterations in their design. One of these is that of an extraction string, facilitating easy removal of the stent.
Patients and Methods: A comprehensive, PRISMA compliant systematic review of the literature was carried out using the PICO method, with the aim of answering the following clinical question: "in patients submitted to previous ureteroscopy procedures for urolithiasis, how did patients with stent-on-string (SOS, intervention) compared to stent-without-string (SWOS, comparator)?".
Result(s): Twenty-Two studies (8382 patients), of which 3427 had a SOS inserted (20 adult,2 paediatric studies). Compared to SWOS, SOS were in situ for less time, with an average of 6.6 and 12.36 days for SOS and SWOS respectively. Further, significant cost savings, less pain on removal and high rates of safe home removal have been reported in SOS when compared to SWOS. Similarly, less urinary symptoms, better visual analogue pain (VAS) score, and readmission and emergency department visits were noted on patients with SOS. A significant drawback identified in the literature is that of stent dislodgement with SOS, with rates ranging from 0 to 15%.
Conclusion(s): Stents on strings provide an excellent option following ureteroscopy, especially in those patients with no intraoperative complication. They reduce dwell time, pain, cost, as well as the risks of prolonged stenting. They might become gold standard in future with more shared decision making and patient reported outcome measures coming into the mainstream.

Harrison N.; Hughes C.; Soman B. (2024). Is stent on a string (SOS) the new gold standard for post-ureteroscopy ureteric drainage? Evidence from a systematic review. Journal of Clinical Urology. 17(1), p.100. [Online]. Available at: https://dx.doi.org/10.1177/20514158241252246 [Accessed 16 January 2026].