Safety of omitting postoperative urethral catheterization after ureteroscopic lithotripsy under general anesthesia: A single-center retrospective study

We evaluated the safety and feasibility of omitting postoperative urethral catheterization after ureteroscopic lithotripsy under general anesthesia. Data from 77 patients who underwent ureteroscopic lithotripsy for upper urinary tract stones between June 2023 and September 2025 were retrospectively reviewed and categorized according to postoperative urethral catheter placement. Perioperative outcomes, including postoperative pain, hematuria, febrile urinary tract infection, and urinary retention, were compared between the groups, and multivariate logistic regression analysis was performed to identify independent predictors of postoperative complications. Patients who underwent postoperative catheterization were significantly older and had longer operative times than those without catheterization. Absence of postoperative urethral catheterization was independently associated with a higher risk of high-grade hematuria; however, the hematuria was transient and clinically insignificant. No significant differences were observed in postoperative pain, febrile urinary tract infection, or urinary retention. These findings indicate that omission of postoperative urethral catheterization after ureteroscopic lithotripsy under general anesthesia is generally safe and does not increase the risk of infection or urinary retention. Routine catheterization appears unnecessary, and selective use may be sufficient in clinical practice.