Optimal Timing for Ureteral Stent Removal After Ureteroscopy to Minimize Morbidity: A Single-Center Prospective Comparative Study.

Objective: To compare patient-reported morbidity across three ureteral stent removal protocols after ureteroscopy (URS) and holmium laser lithotripsy. Patients and Methods: We prospectively recruited 180 patients undergoing URS for unilateral ureteric or renal stones (1-1.5 cm) from January 2021 to December 2024 at a single academic center. All procedures were performed by a single surgeon using a semirigid or flexible ureteroscope, holmium laser lithotripsy, and placement of a 6Fr × 26 cm double-J stent. Patients were sequentially allocated into three groups based on stent removal timing: Group A (24-48 h, Results: Baseline characteristics were similar across groups. Group A had the lowest USSQ total score (68.4 ± 12.6 vs. 76.8 ± 13.4 in Group B vs. 89.7 ± 15.2 in Group C; Conclusion: In this prospective comparative study, stent removal at 24-48 h was associated with lower morbidity, earlier return to activities, and higher patient satisfaction compared to later removal, without an observed increase in complications. These findings suggest that early removal may be beneficial in appropriately selected patients without contraindications. Removal at 3-5 days may represent a practical alternative when earlier removal is not feasible. Adequately powered randomized trials are needed to confirm these findings.