Impact of analysis of risk factors for residual stones after flexible ureteroscopic lithotripsy in patients with upper urinary tract stones

The routine placement of a double-J (DJ) stent before ureteroscopic lithotripsy (URS) remains controversial. This study aims to compare the stone clearance rates between preoperative DJ stent placement and non-placement and to analyze the risk factors associated with residual stones, providing more clinical evidence for preoperative management. A retrospective analysis was conducted on 163 patients who underwent URS for kidney and ureteral stones between April 2023 and October 2024, among which 135 patients met the inclusion criteria. General clinical and perioperative data were collected. The stone clearance rates were compared between the group with preoperative DJ stent placement and the group without DJ stent placement. Univariate and multivariate logistic regression analyses were used to identify risk factors for residual stones after URS. The overall stone clearance rate in patients undergoing URS was 85.19% (115/135). The stone clearance rate in the non-DJ group was 75.51% (37/49), while it was 90.70% (78/86) in the DJ group, showing a statistically significant difference between the 2 groups ( P  = .017). Univariate regression analysis found that the preoperative DJ stent placement ( P  = .021) and surgery duration ( P  = .047) were risk factors for residual stones after URS. Multivariate regression analysis also identified the preoperative DJ stent placement ( P  = .019) and surgery duration ( P  = .039) as independent risk factors for residual stones after URS. Preoperative DJ stent placement resulted in a higher stone clearance rate compared to non-placement during URS. The preoperative DJ stent placement and surgery duration were independent risk factors for residual stones after URS.