Early Stent Removal via Tie-on-Foley Fixation versus Conventional JJ Stenting after Ureteroscopic Lithotripsy: A Retrospective Comparative Study

Abstract Background To compare outcomes between early stent removal using tie-on-Foley fixation and conventional double-J stenting after ureteroscopic lithotripsy. Methods This retrospective study included 262 patients treated between January 2022 and December 2024. Patients were assigned to either the tie-on-Foley group (n = 58), with stent and Foley removed together on postoperative day 2, or the conventional group (n = 204), with stent removal after 2–4 weeks. Outcomes included operative time, pain scores, stone-free rates, and complications. Results The tie-on-Foley group demonstrated significantly shorter mean operative times. While the tie-on-Foley group reported higher visual analogue scale scores at removal (4.06 versus 2.03, p  < 0.001) and required more short-term opioids, they experienced significantly fewer overall postoperative complications (10.3% versus 23.0%, p  = 0.034). Notably, postoperative fever was observed exclusively in the conventional group (8.3% versus 0%, p  = 0.023). Stone-free rates at one month were comparable between groups. Conclusion Early stent removal via tie-on-Foley fixation is a safe strategy for selected patients with small, distal ureteral calculi and low infection risk. While it causes transient discomfort during removal, it is associated with fewer overall complications and avoids the morbidity of prolonged stenting without compromising surgical success. Clinical trial number Not applicable. Trial registration Not applicable.