Impact of the position of the distal end of the ureteral stent and stent-related symptoms in patients with indwelling ureteric stent
DOI:
https://doi.org/10.52786/isu.a.109Keywords:
Position of ureteral stent, ureteral stent-related symptoms, questionnairesAbstract
Objective: A ureteral stent is extensively employed to treat various urologic conditions including ureteral obstruction from external compression, stone, or post-urological procedures. Ureteral stent-related symptoms, such as lower urinary tract symptoms (LUTS), hematuria, and pain, have frequently been found in patients with indwelling ureteral stents. The impact of the position of the distal end of the ureteral stent on stent-related symptoms remains controversial.
Materials and Methods: Twenty-five patients with indwelling ureteral stents undergoing ureteral stent replacement or removal were recruited onto the study. A Thai USSQ was completed before stent replacement or removal. The position of the distal end of the ureteral stent was categorized into 2 groups by Fluoroscopic study or X-ray before stent replacement or removal. The relationship between the position of the distal ureteral stent and the USSQ score was analyzed.
Results: The mean USSQ score was 59 (range 28-112). The majority (60%) of participants had a distal ureteral stent that crossed the midline. The mean stent indwelling time was 2.18+/-1.14 months (range 0.5-4 months). The urinary tract symptoms did not differ significantly between the two groups (OR 1.05, 95%CI 0.92-1.2, p = 0.492). There were also no significant differences between the two groups with regard to the USSQ sub-scores for urinary symptoms (p = 0.509), pain (p = 0.957), general health (p = 0.443), working performance (p = 0.770), sexual symptoms (p = 0.716), and additional problems (p = 0.272). In the case of other factors, the female sex was significantly related to hematuria symptoms (IRR 1.90, 95%CI 1.09-3.73, p = 0.026). The cross-midline group also had significantly higher lower abdominal pain (p = 0.041). Patients with stents that did not cross the midline had significantly fewer symptoms of urinary tract infection (p = 0.035), but there was no significant difference in antibiotic use (p = 0.574) between the two groups.
Conclusion: The position of the distal end of the ureteral stent does not affect urinary symptoms. Discussion with the patient about stent placement, procedure, and related symptoms before and after stent placement remains crucial.
References
Joshi HB, Stainthorpe A, MacDonagh RP, Keeley FX, Jr., Timoney AG, Barry MJ. Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol 2003;169:1065-9; discussion 9.
Abt D, Mordasini L, Warzinek E, Schmid HP, Haile SR, Engeler DS, et al. Is intravesical stent position a predictor of associated morbidity? Korean J Urol 2015;56:370-8.
Dauw CA, Wolf JS. Fundamentals of Upper Urinary Tract Darinage. In: Partin AW, Dmochoski RR, Kavoussi LR, Peters CA, editors. Campbell-walsh-Wein Urology. 12th ed. Philadelphia: Elsevier Saunders; 2020. p. 3152.
Finney RP. Experience with new double J ureteral catheter stent. J Urol 1978;120:678-81.
Lingeman JE, Preminger GM, Goldfischer ER, Krambeck AE. Assessing the impact of ureteral stent design on patient comfort. J Urol 2009;181:2581-7.
Pecoraro A, Peretti D, Tian Z, Aimar R, Niculescu G, Alleva G, et al. Treatment of Ureteral Stent-Related Symptoms. Urol Int 2023;107:288-303.
Giannarini G, Keeley FX, Jr, Valent F, Milesi C, Mogorovich A, Manassero F, et al. The Italian linguistic validation of the ureteral stent symptoms questionnaire. J Urol 2008;180:624-8.
Giannarini G, Keeley FX, Jr., Valent F, Manassero F, Mogorovich A, Autorino R, et al. Predictors of morbidity in patients with indwelling ureteric stents: results of a prospective study using the validated Ureteric Stent Symptoms Questionnaire. BJU Int 2011;107:648-54.
Taguchi M, Yoshida K, Sugi M, Matsuda T, Kinoshita H. A ureteral stent crossing the bladder midline leads to worse urinary symptoms. Cent European J Urol 2017;70:412-7.
Inn FX, Ahmed N, Hou LG, Abidin ZAZ, Yi LL, Zainuddin ZM. Intravesical stent position as a predictor of quality of life in patients with indwelling ureteral stent. International Urology and Nephrol- ogy 2019;51:1949-53.
Andersson KE. Bladder activation: afferent mechanisms. Urology 2002;59:43-50.
El-Nahas AR, El-Assmy AM, Shoma AM, Eraky I, El-Kenawy MR, El-Kappany HA. Self-retaining ureteral stents: analysis of factors responsible for patients’ discomfort. J Endourol 2006;20:33-7.
Rane A, Saleemi A, Cahill D, Sriprasad S, Shrotri N, Tiptaft R. Have stent-related symptoms anything to do with placement technique? J Endourol 2001;15:741-5.
Mosli HA, Farsi HM, al-Zimaity MF, Saleh TR, al-Zamzami MM. Vesicoureteral reflux in patients with double pigtail stents. J Urol 1991;146:966-9.
Chew BH, Knudsen BE, Nott L, Pautler SE, Razvi H, Amann J, et al. Pilot study of ureteral movement in stented patients: first step in understanding dynamic ureteral anatomy to improve stent comfort. J Endourol 2007;21:1069-75.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Insight Urology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
