Cervical cancer ranks as the fourth most common malignancy and cause of cancer-related mortality among women globally [1]. According to data from the International Agency for Research on Cancer (IARC), there were 660,000 newly diagnosed cases and 350,000 deaths from cervical cancer worldwide in 2022 [2]. Due to its large population, China accounts for approximately one-sixth of global new cases and deaths annually, imposing a significant disease burden [3]. Although the global incidence and mortality rates of cervical cancer have shown a declining trend due to the administration of human papillomavirus (HPV) vaccines and the implementation of cervical cancer screening programs, these rates continue to rise in China [4].

Treatment options for cervical cancer include surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. For cervical cancer patients with International Federation of Gynaecology and Obstetrics (FIGO) stages IA1 with lymphovascular space invasion (LVSI), IA2-IIA2, partially resectable IIIC, radical hysterectomy combined with pelvic lymphadenectomy and/or para-aortic lymphadenectomy is the primary treatment, and has achieved favorable outcomes. However, radical hysterectomy involves the removal of extensive parametrial tissues and the upper segment of the vagina, which increases the risk of intraoperative ureteral and bladder injuries and elevates the incidence of postoperative urinary complications [5]. Even experienced gynecologic oncologists may inevitably encounter ureteral injuries. Urinary system injuries are among the most common complications in gynecologic surgeries, often leading to significant adverse effects on patients' quality of life, mental health, and increased costs. Although preoperative placement of ureteral stents may aid in intraoperative identification of the ureters, the routine use of ureteral stents prior to radical hysterectomy to reduce ureteral injury remains controversial.

In this study, we conducted a retrospective analysis of cervical cancer patients who underwent abdominal radical hysterectomy. Patients were stratified into a ureteral stent group and a non-stent group (control group). All surgeries were performed by a single experienced gynecologic oncologist (Zhang. P) over a five-year period. The primary aim was to investigate whether preoperative ureteral stent placement reduces the incidence of intraoperative ureteral injury. The secondary aims included evaluating whether the use of ureteral stent mitigates postoperative ureteral strictures caused by adjuvant radiotherapy, as well as treatment-related morbidity, costs and cost-effectiveness between the two groups.