Ureteral stent related symptoms: A comparative study.

BACKGROUND: In urology, ureteral stents are used to treat obstructive diseases. Hematuria (54%), fever, discomfort, and lower urinary system symptoms are the predominant symptoms related to ureteral stent. AIM: This article links stent symptoms to double-j width and length, as well as patient's height, weight, and body mass index (BMI). Ureteric Stent Symptoms Questionnaire (USSQ) was used to measure ureteral stent symptoms at 1st and 4th week of stent in situ as well as the 4th week after pigtail removal. METHODS: A 200-patient prospective study, where patients were allocated into four groups following ureteral stent insertion depending on the stent characteristics. Those groups were: 4.8 Fr./26 cm (Group A), 4.8 Fr./28 cm (Group B), 6 Fr/26 cm (Group C), and 6 Fr/28 cm (Group D). RESULTS: Men comprised 53.5% of 200 patients. Participants had an average age of 49 ± 15.5 years, height of 175 ± 8.94 cm, and BMI of 23.8 ± 7.6 cm. The laboratory results were identical between groups. At the first and fourth week, groups had similar urine symptoms, pain severity, health status and occupational activities. The difference in pain location was statistically significant. Group A had 82.4% renal back pain in the first week, whereas Group B had 68.8%, Group C 31.3% and Group D 62.5 (p=0.04). At the fourth week, 64.7% of Group A patients reported kidney front pain, compared to 100% of Group B, 93.3% of Group C, and 100% of Group D (p=0.04). There was statistical significance in the sexual activity of the patients. 24.4% of Group C patients stopped sexual activity before stent installation, compared to 10.6%, 8.3%, and 6.4% of the other groups (p=0.03). A moderate percentage of patients had active sexual activity at week 4 (Group A: 7.8%, Group B: 5.8%, Group C: 8.2%, Group D: 4.1%), p=0.83. In multivariate analysis, urinary catheter group, age, weight, height, and BMI did not significantly affect urine index score (UIS), pain index score (PIS), general health (GH), quality of work (QW), and quality of sex (QS). CONCLUSIONS: Despite various attempts to establish the best ureteral stent, the effect of double-j stent physical features on stent-related symptoms remained unknown. No verdict is conceivable without adequate empirical data.

Ureteral Stent-Related Symptoms and Pharmacotherapy: A Brief Narrative Review.

The purpose of this article is to review the effects of different types of pharmacotherapy on symptoms that affect the quality of a patient's life after stent insertion. A thorough Medline/PubMed nonsystematic review was conducted from 1987 to January 2023, using the terms: "pigtail" OR "ureteral stents" AND "lower urinary tracts symptoms" OR "LUTS" AND "pharmacotherapy" OR "drugs". Relevant studies conducted in humans and reported in English language were included. The available reviews and articles associating the use of drugs with stent-related symptoms (SRS) provide conflicting results. Most of them show a clear benefit of alpha blockers, particularly alfuzosin, on treating urinary SRS, and hence there is a strong recommendation for the use of alpha blockers for the treatment of SRS in the guidelines of the European Association of Urology. Anticholinergics and mirabegron have shown a significant benefit in dealing with irritative bladder symptoms. In contrast, the findings for combination therapies are contradictory, with some studies showing that combination therapy is no superior to monotherapy with regards to most of the subsets of the Ureteral Stent Symptom Questionnaire (USSQ), whereas others present a clear benefit of combination therapies, specifically silodosin and solifenacin, in treating stent-associated lower urinary tract symptoms (LUTS), in comparison with any other type of monotherapy or combination therapy. Many studies suggest that some categories of pharmacotherapy, such as alpha blockers, can alleviate SRS. However, there is conflicting evidence concerning most other types of medical treatment. Randomized trials with the largest number of patients are needed to investigate the effectiveness of novel approaches on SRS.