Comparison of the Removal Efficiency and Safety of Magnetic Versus Conventional Ureteral Stents: A Systematic Review and Meta-analysis

CONTEXT: The incidence of urolithiasis is increasing year by year. Ureteral stents are a popular treatment option for this condition. Efforts to improve the material and structure of stents to increase comfort and reduce complications have led to the introduction of magnetic stents. OBJECTIVE: To evaluate differences in removal efficiency and safety for magnetic and conventional stents. EVIDENCE ACQUISITION: This study was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Data were extracted according to the PRISMA principles. We collected and combined data from randomized controlled trials on magnetic versus conventional stents to evaluate the efficiency of their removal and the associated effects. Data synthesis was performed using RevMan 5.4.1 and heterogeneity was evaluated using I(2) tests. A sensitivity analysis was also performed. Key metrics included the stent removal time, Visual Analog Scale (VAS) pain scores, and Ureteral Stent Symptom Questionnaire (USSQ) scores for various domains. EVIDENCE SYNTHESIS: Seven studies were included in the review. We found that magnetic stents had a shorter removal time (mean difference [MD] −8.28 min, 95% confidence interval [CI] −15.6 to −0.95; p = 0.03) and their removal was associated with less pain (MD −3.01 points, 95% CI −3.83 to −2.19; p < 0.01) in comparison to conventional stents. USSQ scores for urinary symptoms and sexual matters were higher for magnetic than for conventional stents. There were no other differences between the stent types. CONCLUSIONS: Magnetic ureteral stents have the advantages of a shorter removal time, less pain during removal, and low cost in comparison to conventional stents. PATIENT SUMMARY: For patients undergoing treatment of urinary stones, a thin tube called a stent is often temporarily inserted in the tube between the kidney and the bladder to allow stones to pass. Magnetic stents can be removed without any need for a second surgical procedure. Our review of studies comparing two types of stents suggests that magnetic stents are superior to conventional stents in terms of efficiency and comfort during removal.