AB010. SOH26AB_0053. A systematic review on the insertion of JJ stent on extraction strings versus without extraction strings: patients’ outcomes and cost-effectiveness
Urology Session

AB010. SOH26AB_0053. A systematic review on the insertion of JJ stent on extraction strings versus without extraction strings: patients’ outcomes and cost-effectiveness

Lugman Ahmed, Ahmed Aydrose, Ahmed Ahmed, Mamoun Abdelrahman

Department of Urology, Limerick University Hospital, Limerick, Ireland

Background: Ureteric stents are routinely used following endourological procedures such as ureteroscopy. Traditionally, stent removal requires cystoscopy; however, stents with extraction strings have been introduced to facilitate simpler, outpatient, or self-removal. Despite their increasing use, concerns remain regarding dislodgement, infection risk, patient tolerability, and overall cost-effectiveness. This systematic review compares clinical outcomes, patient tolerability, complication rates, and cost implications of ureteric stents with extraction strings versus standard stents without strings.

Methods: A comprehensive search of PubMed, Embase, and Cochrane Library identified English-language randomized controlled trials published between 2019 and 2024. Four eligible studies comprising 641 patients were included: 305 received stents with extraction strings and 336 received stents without strings. Extracted data included demographics, complications, pain scores, urinary symptoms, stent dwell time, removal method, and cost estimates.

Results: Across studies, pain during stent removal was consistently lower in the extraction-string group. No significant differences were observed in urinary symptoms or overall morbidity between groups. Dislodgement occurred in 1.6% of patients with extraction strings; no cases occurred in the comparator group. Urinary tract infection rates were comparable, though one study reported a slight increase with extraction strings. Most patients with extraction strings were able to remove their stents at home, reducing clinic visits and procedural costs. Estimated savings reached up to $243 per patient due to the avoidance of cystoscopic removal.

Conclusions: Stents with extraction strings provide safe, effective, and well-tolerated removal with reduced pain and meaningful cost savings. Although dislodgement risk is slightly increased, extraction strings represent a viable option for appropriately selected patients.

Keywords: JJ stent; DJ stent; double J stent; cost-effectiveness; extraction strings

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab010
Cite this abstract as: Ahmed L, Aydrose A, Ahmed A, Abdelrahman M. AB010. SOH26AB_0053. A systematic review on the insertion of JJ stent on extraction strings versus without extraction strings: patients’ outcomes and cost-effectiveness. Mesentery Peritoneum 2026;10:AB010.

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