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Corticosteroids in Urology

Corticosteroids are used in six discrete urologic domains: perioperative antiemesis and analgesia (ERAS), metastatic castration-resistant prostate cancer (abiraterone co-administration, steroid switch, standalone secondary hormonal therapy), renal-transplant immunosuppression and rejection treatment, contrast-allergy premedication for urologic imaging, interstitial cystitis / bladder pain syndrome with Hunner lesions, and investigational adjunctive medical-expulsive therapy for distal ureteral stones.[1][9][16][19][25][27] Each role has its own agent preference, dose, and evidence profile, and evidence from one indication must not be generalized to another.

This article is the drug-class pharmacology hub — agents, doses, and indication-by-indication evidence. Perioperative stress dosing of the chronic-steroid-using patient, adrenal-crisis recognition and treatment, and the wound-healing consequences of chronic steroids on urethroplasty / prosthetic / bowel-anastomotic reconstruction are covered separately at Perioperative steroids — that page is workflow-focused and should not be duplicated here.

For the topical / intralesional counterparts see High-potency topical corticosteroids (genital LS, vulvar dermatoses) and Intralesional corticosteroids (urethral-stricture adjunct, keloids).

Agent Selection at a Glance​

AgentRelative anti-inflammatory potencyDurationTypical urologic dose / routeBest-supported indication
Dexamethasone25–30× hydrocortisone36–72 h (long-acting)4–8 mg IV single dose; 0.5 mg PO dailyPONV prophylaxis; mCRPC steroid switch
Methylprednisolone~5× hydrocortisone12–36 h250–500 mg IV pulse × 3 d; 32 mg POAcute cellular rejection; contrast premed
Prednisone~4× hydrocortisone12–36 hAbiraterone regimen depends on cancer setting / formulationGlucocorticoid co-administration with selected prostate-cancer treatments; not routine long-term IC/BPS therapy
Deflazacort~3× hydrocortisone12–36 hStudied off label in small stone trialsNot established routine MET
Hydrocortisone1× (reference)8–12 hStress dosing onlyAdrenal-insufficiency coverage — see Perioperative steroids

1. Dexamethasone — Perioperative Antiemesis and Analgesia​

PONV prophylaxis is the commonest perioperative use in urologic surgery — particularly after laparoscopic / robotic nephrectomy, prostatectomy, pyeloplasty, and any case with steep Trendelenburg.

QuestionAnswerEvidence
Dose4–8 mg IV, usually at induction, as one component of risk-based PONV preventionFifth Consensus Guidelines (2025) and earlier dose meta-analysis; assess glucose and cumulative steroid exposure[2][37]
TimingAt inductionStandard
CombinationDex + 5-HT₃ antagonist (ondansetron) > 5-HT₃ alone for laparoscopic casesSom 2016 meta — OR 0.38; NNT 6.6[3]
PADDI substudyDex 8 mg IV ↓ PONV incidence and severity; ↓ day-2 severe PONV (RR 0.58; p = 0.02); primary composite endpoint did not reach significanceCorcoran 2022[4]

Perioperative analgesia / ERAS incorporation​

  • ≥ 0.1 mg/kg IV reduces pain scores at rest and with movement at 2 h and 24 h with opioid-sparing effect (De Oliveira 2011 meta, 24 RCTs, n = 2,751).[5]
  • Dose-subgroup comparisons in the 2011 review did not demonstrate greater benefit above 0.2 mg/kg; indirect subgroup results are not proof of dose equivalence or a mandate to escalate.[5]
  • High-dose (≥ 15 mg) (Laconi 2024 meta, 47 RCTs, n = 3,943) — ↓ rescue opioid by 10 mg oral-morphine-equivalents; OR 0.29 for PONV; modest VAS reduction (−6.18 mm at 24 h); no detected increase in pooled major AEs (OR 0.88), which does not establish safety of high doses for every patient or operation.[6]
  • Postoperative sore throat — dex ≥ 0.2 mg/kg within 30 min of induction ↓ sore throat (OR 0.44) and hoarseness (OR 0.42) — relevant for steep-Trendelenburg RARP / RARC with prolonged intubation.[7]
  • Peripheral nerve block prolongation — perineural or IV dexamethasone has been studied as an adjunct. Perineural administration is off label, and results from other blocks cannot be assumed to validate every GU block / admixture.[8]

Safety — single-dose perioperative dexamethasone​

PADDI 2021 provides large randomized safety evidence: 8,880 adults undergoing nonurgent noncardiac surgery were randomized to dexamethasone 8 mg IV or placebo; 8,678 had the primary SSI assessment. Infection occurred in 8.1% versus 9.1%, meeting the prespecified 2-percentage-point noninferiority margin. Results were similar in the diabetes subgroup. PONV was reduced (42.2% versus 53.9%); hyperglycemic events in patients without diabetes were more frequent (0.6% versus 0.2%). These findings concern a single 8-mg dose, not chronic or repeated high-dose therapy.[36]

The older Polderman Cochrane review included 37 studies overall; its infection analysis used 26 studies / 4,603 participants and found probably little or no difference (Peto OR 1.01; 95% CI 0.80–1.27). Delayed wound healing remained uncertain (eight studies / 1,072; OR 0.99, 95% CI 0.28–3.43), and higher-risk patients were excluded from those wound-healing trials. It also documented transient glucose increases. Lack of detected infection harm is not proof that all steroid doses are safe for wound healing.[1][28]

Coordinate glucose management in diabetics (see Diabetes).

2. Corticosteroids in Metastatic Castration-Resistant Prostate Cancer​

The most nuanced use of corticosteroids in urology — and the one most often changing at the reconstructive-urology / uro-oncology interface.

Abiraterone co-administration — required to prevent mineralocorticoid excess​

Abiraterone blocks CYP17 → adrenal cortisol synthesis drops → compensatory ACTH rise → mineralocorticoid excess (HTN, hypokalemia, edema). Concurrent glucocorticoid suppresses the ACTH drive.[9]

US product-label regimens: Zytiga and Yonsa have different doses / instructions and are not interchangeable solely by changing the steroid.[9][38]

SettingRegimen
Standard abiraterone + prednisone (CRPC)Prednisone 5 mg PO BID
Zytiga + prednisone (metastatic high-risk CSPC)Prednisone 5 mg PO daily
Fine-particle abiraterone (Yonsa)Methylprednisolone 4 mg PO BID

The prednisone → dexamethasone "steroid switch" at progression​

When mCRPC progresses on abiraterone + prednisone, a switch to abiraterone + dexamethasone 0.5 mg daily has produced PSA responses in selected clinically stable patients with limited progression. This is an oncology-directed option supported by small / nonrandomized studies, not proof of survival benefit or a substitute for reassessing next-line therapy.[10]

StudynPSA₃₀PSA₅₀Outcome
SWITCH phase II (Romero-Laorden 2018)2646.2%34.6%Median biochem PFS 5.3 mo; radiologic PFS 11.8 mo; Exploratory ctDNA AR-gain association with non-response[10]
Yang 2021 (retrospective, China)13046.2%29.2%PFS 5.0 mo, OS 18.7 mo; Exploratory clinical predictors; not prospectively validated selection rules[11]
AbiDex (UK, Muller 2022)33——73% rebound biochem response; bPFS 9 mo (AA+P) → 19 mo (AA+P then AA+D) (HR 0.28)[12]

Proposed mechanisms: long-term prednisone may drive resistance via glucocorticoid-receptor (GR) activation — the GR has substantial overlap with AR DNA-binding sites and can rescue expression of AR-regulated genes.[13][14] Clinical response cannot be inferred from relative GR potency alone; the biology is not a validated bedside biomarker. AR point mutations activated by glucocorticoids may additionally cause steroid-specific resistance.[14]

Glucocorticoids as standalone secondary hormonal therapy​

  • Prednisone 5 mg BID or dexamethasone 0.5 mg daily induces PSA responses in ~24% of mCRPC patients as monotherapy.[14]
  • Venkitaraman 2015 randomized phase 2 (82 men) — confirmed PSA responses in the intention-to-treat comparison were 41% versus 22% for daily dexamethasone versus prednisolone (p = 0.08). The 47% versus 24% result (p = 0.05) was restricted to evaluable patients. This small trial did not establish a survival advantage.[15]
  • COU-AA-302 placebo arm — 24% achieved > 50% PSA decline on prednisone + placebo; 16% had objective response.[14]

Chemotherapy co-administration​

Corticosteroid co-administration and taxane premedication depend on the exact oncology regimen. Do not independently omit maintenance prednisone on an infusion day; reconcile it with dexamethasone and adrenal-risk coverage through the treating team.[14]

The critical caveat — glucocorticoids as disease drivers​

GR-mediated resistance is a mechanistic concern, not a reason to abruptly stop a required steroid. Reassess progressing disease with oncology; abiraterone-associated mineralocorticoid excess and adrenal insufficiency after steroid interruption remain clinical risks. Any steroid switch / taper must fit the complete treatment plan.[9][14]

3. Methylprednisolone in Renal Transplantation​

Induction and maintenance. Standard triple immunosuppression is tacrolimus + antimetabolite (mycophenolate) + low-dose glucocorticoids. Adequate tacrolimus exposure with low-dose glucocorticoids and antimetabolite is central to preventing early acute rejection and de novo donor-specific antibodies.[19]

Suspected acute rejection requires transplant-team assessment and usually biopsy, unless biopsy would substantially delay necessary treatment. KDIGO recommends corticosteroids initially for acute cellular rejection; pulse methylprednisolone is commonly used under the transplant protocol. The optimal regimen depends on histology, severity and response.[20][21]

Persistent histologic inflammation in older studies does not justify a universal rule to wait five days before escalating treatment. Clinical graft dysfunction and biopsy findings guide reassessment. Resistant or recurrent cellular rejection may require lymphocyte-depleting therapy; antibody-mediated rejection requires a distinct, individualized regimen. Do not apply a blanket 60–70% response estimate or automatic steroid / plasmapheresis / IVIG combination to every rejection type.[19][20][22]

Early steroid withdrawal: Woodle 2021 followed a randomized cohort of low- to moderate-immune-risk recipients without delayed graft function or first-week rejection, receiving tacrolimus / mycophenolate. At median 15.8 years, there was no detected difference in allograft failure (adjusted HR 0.83; 95% CI 0.62–1.10). This supports a selected transplant strategy, not universal withdrawal or proof of equivalence for high-risk recipients.[23]

4. Contrast-Allergy Premedication​

For prior iodinated-contrast reactions, the 2025 ACR/AAAAI consensus uses reaction severity:[17][18]

  • Mild immediate reaction: premedication is not recommended; switch the culprit agent when feasible.
  • Moderate immediate reaction: switch when feasible; premedication may be considered.
  • Severe immediate reaction: first consider alternative imaging. If iodinated contrast remains necessary, switch when feasible and premedicate; use a hospital setting with personnel and equipment for anaphylaxis.

This is not a blanket protocol for gadolinium, physiologic reactions or an “iodine / shellfish allergy” label. Record the actual agent and reaction; prophylaxis does not eliminate anaphylaxis risk.

When an elective oral regimen is selected, the ACR Manual 2026 lists:[16]

RegimenTiming before contrast
Prednisone 50 mg PO13 h, 7 h and 1 h
Methylprednisolone 32 mg PO12 h and 2 h
Diphenhydramine 50 mg, if used1 h; the manual considers this adjunct optional

An accelerated IV regimen takes 4–5 hours; shorter courses have not demonstrated efficacy. This does not mean urgent imaging must always wait. If delay is unsafe, radiology and the treating team should agree on alternatives or monitored contrast administration with resuscitation capability. Consider hyperglycemia, sedation from antihistamines and diagnostic delay when deciding whether to premedicate.[16]

5. Prednisone in Interstitial Cystitis / Bladder Pain Syndrome​

AUA 2022 advises against long-term oral glucocorticoids for IC/BPS because serious harms outweigh the limited evidence of benefit. Its discussion does not preclude a short course for a flare, but this is not endorsement of chronic prednisone for refractory Hunner lesions.[25]

Soucy 2005 reported improvement in a small uncontrolled refractory-ulcerative-IC series. That historical observation does not override the guideline or provide a routine dosing regimen. Hunner-lesion treatment and selected refractory disease should follow the dedicated bladder-directed pathway; intralesional triamcinolone is distinct from systemic prednisone.[25][26]

For the full IC/PBS framework including intravesical therapy, see the class-level IC/PBS clinical article and the intravesical IC/BPS agents hub.

6. Corticosteroids as MET Adjunct for Distal Ureteral Stones​

Small trials have studied off-label corticosteroids with α-blockers for distal stone expulsion:

  • Porpiglia 2006 (prospective) — tamsulosin + deflazacort 30 mg/day × 10 d: 84.8% expulsion vs tamsulosin alone 60% vs deflazacort alone 37.5% vs analgesics only 33.3% (p < 0.001)[27]
  • This trial did not establish benefit from deflazacort monotherapy (37.5% expulsion versus 33.3% with analgesics)[27]

EAU 2026 notes combination-study signals but its recommendation is to offer α-blockers for selected distal stones 5–10 mm. It does not make routine deflazacort a standard treatment. Balance infection, glucose and other steroid risks; analgesia and urgent drainage indications take priority.[39]

7. Niche Applications​

  • Post-ureteroscopy pain/inflammation — Hamidi 2018 matched-pair analysis (n = 144) found methylprednisolone after uncomplicated unstented URS ↓ pain scores (POD 0: 3.3 vs 3.9, p = 0.012; POD 1: 2.8 vs 3.4, p = 0.02), ↓ renal-colic episodes (4.2% vs 13.2%, p = 0.036), and ↓ parenteral analgesic consumption (18 vs 36 mg, p = 0.009).[24]
  • Fournier gangrene — not standard (management is surgical debridement + broad-spectrum antibiotics + resuscitation).[30][31] A historical case report involving necrotizing vasculitis is not evidence for treating infectious Fournier gangrene with immunosuppression or delaying source control. Steroid use for a separately established inflammatory disease or shock has a different indication.[29]
  • Idiopathic segmental ureteritis — case report of successful prednisolone treatment of bilateral idiopathic segmental ureteritis after ureteral stenting failed.[32]
  • Ureteral stent-related symptoms — α-blockers are first-line; corticosteroids have no established routine role for this indication in the cited evidence. Patient factors (age, depression, chronic pain) drive stent-symptom intensity more than surgical factors.[33][34][35]

Cross-Reference — What's Covered on the Perioperative Steroids Page​

To avoid duplication, the following sit at Perioperative steroids:

TopicWhere it lives
Chronic-steroid patient identification (who is at risk of adrenal crisis)Perioperative steroids
Stress-dose regimens by surgical complexity (minor / moderate / major)Perioperative steroids
Adrenal-crisis recognition and treatmentPerioperative steroids
Wound-healing consequences of chronic steroids on urethroplasty / prosthetics / bowel anastomosisPerioperative steroids
Preop mitigation (taper before elective reconstruction)Perioperative steroids
Dexamethasone 4–8 mg at induction as an adjunctBrief on both pages — this article for drug-class pharmacology and evidence, perioperative page for the OR workflow including interaction with stress-dose coverage

Keep the two articles separate: one is about managing chronic-steroid patients in the perioperative period, the other is about corticosteroid-class pharmacology across six indications. They cross-link but do not consolidate.

Practical Pearls​

  • Single-dose dexamethasone 4–8 mg is a PONV option. PADDI supports SSI safety for one 8-mg dose; monitor glucose and avoid extending that conclusion to chronic or repeated high-dose exposure.[36][37]
  • Reconcile steroid indications and total exposure. Stress-dose coverage is not automatically a validated antiemetic regimen. Coordinate adrenal replacement and PONV prophylaxis with anesthesia rather than adding or omitting steroids reflexively.
  • mCRPC steroid switching is oncology-directed. Small studies show PSA responses in selected patients; this does not establish survival benefit or justify abrupt steroid withdrawal.[9][10][11][12]
  • Treat transplant rejection according to phenotype and response. Do not delay specialist reassessment until an arbitrary fifth day.[20]
  • Contrast premedication is selective. Correct methylprednisolone timing is 12 h and 2 h; consider the 2025 severity-based consensus before ordering any regimen.[16][17]
  • Long-term systemic steroids are not recommended for IC/BPS; routine steroid MET is not established. Small-series responses should not become default treatment algorithms.[25][39]
  • For stress dosing, adrenal crisis and chronic-steroid wound effects, use Perioperative steroids.

See Also​

References​

1. Polderman JA, Farhang-Razi V, Van Dieren S, et al. "Adverse side effects of dexamethasone in surgical patients." Cochrane Database Syst Rev. 2018;11:CD011940. doi:10.1002/14651858.CD011940.pub3

2. De Oliveira GS, Castro-Alves LJ, Ahmad S, Kendall MC, McCarthy RJ. "Dexamethasone to prevent postoperative nausea and vomiting: an updated meta-analysis of randomized controlled trials." Anesth Analg. 2013;116(1):58–74. doi:10.1213/ANE.0b013e31826f0a0a

3. Som A, Bhattacharjee S, Maitra S, Arora MK, Baidya DK. "Combination of 5-HT3 antagonist and dexamethasone is superior to 5-HT3 antagonist alone for PONV prophylaxis after laparoscopic surgeries: a meta-analysis." Anesth Analg. 2016;123(6):1418–1426. doi:10.1213/ANE.0000000000001617

4. Corcoran TB, Martin C, O'Loughlin E, et al. "Dexamethasone and clinically significant postoperative nausea and vomiting: a prespecified substudy of the randomised Perioperative Administration of Dexamethasone and Infection (PADDI) trial." Br J Anaesth. 2022;129(3):327–335. doi:10.1016/j.bja.2022.05.018

5. De Oliveira GS, Almeida MD, Benzon HT, McCarthy RJ. "Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials." Anesthesiology. 2011;115(3):575–588. doi:10.1097/ALN.0b013e31822a24c2

6. Laconi G, Coppens S, Roofthooft E, Van De Velde M. "High dose glucocorticoids for treatment of postoperative pain: a systematic review of the literature and meta-analysis." J Clin Anesth. 2024;93:111352. doi:10.1016/j.jclinane.2023.111352

7. Jiang Y, Chen R, Xu S, et al. "The impact of prophylactic dexamethasone on postoperative sore throat: an updated systematic review and meta-analysis." J Pain Res. 2018;11:2463–2475. doi:10.2147/JPR.S172419

8. Pehora C, Pearson AM, Kaushal A, Crawford MW, Johnston B. "Dexamethasone as an adjuvant to peripheral nerve block." Cochrane Database Syst Rev. 2017;11:CD011770. doi:10.1002/14651858.CD011770.pub2

9. ZYTIGA (abiraterone acetate): US prescribing information, revised November 2024. Label. Accessed September 12, 2026.

10. Romero-Laorden N, Lozano R, Jayaram A, et al. "Phase II pilot study of the prednisone to dexamethasone switch in metastatic castration-resistant prostate cancer (mCRPC) patients with limited progression on abiraterone plus prednisone (SWITCH Study)." Br J Cancer. 2018;119(9):1052–1059. doi:10.1038/s41416-018-0123-9

11. Yang Z, Ni Y, Zhao D, et al. "Corticosteroid switch from prednisone to dexamethasone in metastatic castration-resistant prostate cancer patients with biochemical progression on abiraterone acetate plus prednisone." BMC Cancer. 2021;21(1):919. doi:10.1186/s12885-021-08670-2

12. Muller D, Leaper A, Yadollahi S, et al. "AbiDex: retrospective UK analysis of steroid switching in patients with progression of mCRPC treated with abiraterone acetate." J Clin Oncol. 2022;40(6 Suppl):114. doi:10.1200/JCO.2022.40.6_suppl.114

13. Teo MY, Scher HI. "Lessons from the SWITCH trial: changing glucocorticoids in the management of metastatic castration-resistant prostate cancer (mCRPC)." Br J Cancer. 2018;119(9):1041–1043. doi:10.1038/s41416-018-0239-y

14. Lorente D, Mateo J, Perez-Lopez R, de Bono JS, Attard G. "Sequencing of agents in castration-resistant prostate cancer." Lancet Oncol. 2015;16(6):e279–e292. doi:10.1016/S1470-2045(15)70033-1

15. Venkitaraman R, Lorente D, Murthy V, et al. "A randomised phase 2 trial of dexamethasone versus prednisolone in castration-resistant prostate cancer." Eur Urol. 2015;67(4):673–679. doi:10.1016/j.eururo.2014.10.004

16. American College of Radiology. ACR Manual on Contrast Media. 2026. Patient selection and preparation chapter. Manual.

17. Wang C, Ramsey A, Lang D, et al. "Management and prevention of hypersensitivity reactions to radiocontrast media: a consensus statement from the American College of Radiology and the American Academy of Allergy, Asthma & Immunology." Radiology. 2025;315(2):e240100. doi:10.1148/radiol.240100

18. Wang C, Ramsey A, Lang D, et al. "Management and prevention of hypersensitivity reactions to radiocontrast media: a consensus statement from the ACR and AAAAI." J Allergy Clin Immunol Pract. 2025. doi:10.1016/j.jaip.2025.01.042

19. Hariharan S, Israni AK, Danovitch G. "Long-term survival after kidney transplantation." N Engl J Med. 2021;385(8):729–743. doi:10.1056/NEJMra2014530

20. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. "KDIGO clinical practice guideline for the care of kidney transplant recipients." Am J Transplant. 2009;9(Suppl 3):S1–S155. doi:10.1111/j.1600-6143.2009.02834.x

21. Bock HA. "Steroid-resistant kidney transplant rejection: diagnosis and treatment." J Am Soc Nephrol. 2001;12(Suppl 17):S48–S52.

22. Mazzucchi E, Lucon AM, Nahas WC, et al. "Histological outcome of acute cellular rejection in kidney transplantation after treatment with methylprednisolone." Transplantation. 1999;67(3):430–434. doi:10.1097/00007890-199902150-00016

23. Woodle ES, Gill JS, Clark S, et al. "Early corticosteroid cessation vs long-term corticosteroid therapy in kidney transplant recipients: long-term outcomes of a randomized clinical trial." JAMA Surg. 2021;156(4):307–314. doi:10.1001/jamasurg.2020.6929

24. Hamidi N, Ozturk E, Yikilmaz TN, Atmaca AF, Basar H. "The effect of corticosteroid on postoperative early pain, renal colic and total analgesic consumption after uncomplicated and unstented ureteroscopy: a matched-pair analysis." World J Urol. 2018;36(6):979–984. doi:10.1007/s00345-018-2210-1

25. Clemens JQ, Erickson DR, Varela NP, Lai HH. "Diagnosis and treatment of interstitial cystitis/bladder pain syndrome." J Urol. 2022;208(1):34–42. doi:10.1097/JU.0000000000002756

26. Soucy F, Grégoire M. "Efficacy of prednisone for severe refractory ulcerative interstitial cystitis." J Urol. 2005;173(3):841–843. doi:10.1097/01.ju.0000153612.14639.19

27. Porpiglia F, Vaccino D, Billia M, et al. "Corticosteroids and tamsulosin in the medical expulsive therapy for symptomatic distal ureter stones: single drug or association?" Eur Urol. 2006;50(2):339–344. doi:10.1016/j.eururo.2006.02.023

28. Toner AJ, Ganeshanathan V, Chan MT, Ho KM, Corcoran TB. "Safety of perioperative glucocorticoids in elective noncardiac surgery: a systematic review and meta-analysis." Anesthesiology. 2017;126(2):234–248. doi:10.1097/ALN.0000000000001466

29. Schultz ES, Diepgen TL, von den Driesch P, Hornstein OP. "Systemic corticosteroids are important in the treatment of Fournier's gangrene: a case report." Br J Dermatol. 1995;133(4):633–635. doi:10.1111/j.1365-2133.1995.tb02719.x

30. Montrief T, Long B, Koyfman A, Auerbach J. "Fournier gangrene: a review for emergency clinicians." J Emerg Med. 2019;57(4):488–500. doi:10.1016/j.jemermed.2019.06.023

31. Hagedorn JC, Wessells H. "A contemporary update on Fournier's gangrene." Nat Rev Urol. 2017;14(4):205–214. doi:10.1038/nrurol.2016.243

32. Atsuta T, Shimizu Y, Masuda N, et al. "First report of idiopathic segmental ureteritis successfully treated by steroid therapy." Int J Urol. 2012;19(6):583–586. doi:10.1111/j.1442-2042.2012.02968.x

33. Koprowski C, Kim C, Modi PK, Elsamra SE. "Ureteral stent-associated pain: a review." J Endourol. 2016;30(7):744–753. doi:10.1089/end.2016.0129

34. Betschart P, Zumstein V, Piller A, Schmid HP, Abt D. "Prevention and treatment of symptoms associated with indwelling ureteral stents: a systematic review." Int J Urol. 2017;24(4):250–259. doi:10.1111/iju.13311

35. Harper JD, Desai AC, Maalouf NM, et al. "Risk factors for increased stent-associated symptoms following ureteroscopy for urinary stones: results from STENTS." J Urol. 2023;209(5):971–980. doi:10.1097/JU.0000000000003183

36. Corcoran TB, et al. Dexamethasone and Surgical-Site Infection. NEJM. 2021. PADDI trial. Primary source. Accessed September 12, 2026.

37. Gan TJ, et al. Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting: Executive Summary. 2025. Primary source. Accessed September 12, 2026.

38. YONSA (abiraterone acetate): US prescribing information. Primary source. Accessed September 12, 2026.

39. EAU Guidelines on Urolithiasis 2026. Medical expulsive therapy. Primary source. Accessed September 12, 2026.