Top

World Journal of Urology

Published in:

01-04-2020 | Ureterorenoscopy | Original Article

Size does matter: ureteral stents with a smaller diameter show advantages regarding urinary symptoms, pain levels and general health

Authors: Sebastian Nestler, B. Witte, L. Schilchegger, J. Jones

Published in: World Journal of Urology | Issue 4/2020

Abstract

Objective

To compare the effect of different diameters of ureteral stents (F4.7, F6, and F7) on quality of life regarding the subdomains of the Ureteral Stent Symptom Questionnaire.

Materials and methods

All patients undergoing URS between April 2016 and July 2017 were prospectively randomised for ureteral stents F4.7, F6 and F7, respectively. All patients with other pathologies than a ureter stone, ureteral stents on both sides or other therapy than a secondary URS were excluded. Readmitted patients were interviewed using the USSQ. Furthermore, success rates of the second URS were also noted.

Results

Between April 2016 to July 2017, 181 patients were included, 48 with a ureteral stent F4.6, 66 with F6 and 67 with F7. No significant differences in age, gender or position of the stones before URS were found (all p > 0.5). Comparing scores of USSQ between F4.7 and F6 or F6 and F7, scores were in favour of the smaller stent, but significance was only reached in “Work performance score” (F6–F7, p = 0.04) and “Urinary index score” (F4.7–F6, p = 0.004). When comparing F4.7 with F7, significant differences in all subgroups in favour of F4.7 were documented (all p < 0.03). Surgical success of the second URS was comparable in all groups (all above 82%, p > 0.15).

Conclusion

Discomfort and pain increase with the diameter of the indwelling ureter stent, while the success of the following URS is not compromised by a ureter stent with a smaller diameter. Therefore, ureteral stents with a small diameter should be preferred.

Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T (2016) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 69:468–474CrossRef

Bozkurt OF, Resorlu B, Yildiz Y, Can CE, Unsal A (2011) Retrograde intrarenal surgery versus percutaneous nephrolithotomy in the management of lower pole renal stones with a diameter of 15–20 mm. J Endourol 25:1131–1135CrossRef

Geavlete P, Georgescu D, Niţă G, Mirciulescu V, Cauni V (2006) Complications of 2735 retrograde semirigid ureteroscopy procedure: a single centre experience. J Endourol 20:179–185CrossRef

Grasso M, Conlin M, Bagley D (1998) Retrograde ureteropyeloscopic treatment of 2 cm or greater upper urinary tract and minor Staghorn calculi. J Urol 160(2):346–351CrossRef

Tolley D (2000) Ureteric stents, far from ideal. Lancet 356:872–873CrossRef

Joshi HB, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG, Barry MJ (2003) Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol 169:1065–1069CrossRef

Bosio A, Alessandria E, Dalmasso E, Peretti D, Agosti S, Bisconti A, Destefanis P, Passera R, Gontero P (2019) How bothersome double-J ureteral stents are after semirigid and flexible ureteroscopy: a prospective single-institution observational study. World J Urol 37(1):201–207CrossRef

Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney (2003) Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol 169:1060–1064CrossRef

Abt D, Dötzer K, Honek P, Müller K, Engeler DS, Burger M, Schmid HP, Knoll T, Sanguedolce F, Joshi HB, Fritsche HM (2017) The german linguistic validation of the ureteral stent symptoms questionnaire (USSQ). World J Urol 35(3):443–447CrossRef

10.

Damiano R, Autorino R, De Sio M, Cantiello F, Quarto G, Perdonà S, Sacco R, D’Armiento M (2005) Does the size of ureteral stent impact urinary symptoms and quality of life? A prospective randomized study. Eur Urol 48:673–678CrossRef

11.

Joshi HB, Chitale SV, Nagarajan M, Irving SO, Browning AJ, Biyani CS, Burgess NA (2005) A prospective randomised single-blind comparison of ureteral stents composed of firm and soft polymer. J Urol 174:2303–2306CrossRef

12.

Hendlin K, Dockendorf K, Horn C, Pshon N, Lund B, Monga M (2006) Ureteral stents: coil strength and durometer. Urology 68:42–45CrossRef

13.

Davenport K, Kumar V, Collins J, Melotti R, Timoney AG, Keeley FX Jr (2011) New ureteral stent design does not improve patient quality of Life: a randomized, controlled trial. J Urol 185:175–178CrossRef

14.

Park HK, Paick SH, Kim HG, Lho YS, Bae S (2015) The Impact of ureteral stent type on patient symptoms as determined by the ureteral stent symptom questionnaire: a prospective, randomized, controlled study. J Endourol 29:367–371CrossRef

15.

Al-Kandari AM, Al-Shaiji TF, Shaaban H, Ibrahim HM, Elshebiny YH, Shokeir AA (2007) Effects of proximal and distal ends of double-J ureteral stent position on postprocedural symptoms and quality of life: a randomized clinical trial. J Endourol 21:698–702CrossRef

16.

Liatsikos EN, Gershbaum D, Kapoor R, Fogarty J, Dinlenc CZ, Bernardo NO, Smith AD (2001) Comparison of symptoms related to positioning of double-pigtail stent in upper pole versus renal pelvis. J Endourol 15:299–302CrossRef

17.

Ho CH, Chen SC, Chung SD, Lee YJ, Chen J, Yu HJ, Huang KH (2008) Determining the appropriate length of a double-pigtail ureteral stent by both stent configurations and related symptoms. J Endourol 22:1427–1431CrossRef

18.

Cubuk A, Yanaral F, Ozgor F, Savun M, Ozdemir H, Erbin A, Yuksel B, Sarilar O (2018) Comparison of 4.8Fr and 6Fr ureteral stents on stent related symptoms following ureterorenoscopy: a prospective randomized controlled trial. Kaohsiung J Med Sci 34(12):695–699CrossRef

19.

Erturk E, Sessions A, Joseph JV (2003) Impact of ureteral stent diameter on symptoms and tolerability. J Endourol 17(2):59–62CrossRef

20.

Candela JV, Bellman GC (1997) Ureteral stents: impact of diameter and composition on patient symptoms. J Endourol 11(1):45–47CrossRef

21.

Vogt B, Desfemmes FN, Desgrippes A, Ponsot Y (2016) MiniJFil: a new safe and effective stent for well-tolerated repeated extracorporeal shockwave lithotripsy or ureteroscopy for medium-to-large kidney stones. Nephrourol Mon 8(5):e40788CrossRef

Title: Size does matter: ureteral stents with a smaller diameter show advantages regarding urinary symptoms, pain levels and general health
Authors: Sebastian Nestler
B. Witte
L. Schilchegger
J. Jones
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keyword: Ureterorenoscopy
Published in: World Journal of Urology / Issue 4/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02829-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Size does matter: ureteral stents with a smaller diameter show advantages regarding urinary symptoms, pain levels and general health

Abstract

Objective

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2020

One-Stop MRI and MRI/transrectal ultrasound fusion-guided biopsy: an expedited pathway for prostate cancer diagnosis

The evolution and resurgence of perineal prostatectomy in the robotic surgical era

Best practices in near-infrared fluorescence imaging with indocyanine green (NIRF/ICG)-guided robotic urologic surgery: a systematic review-based expert consensus

Robotic surgery in urology: the way forward

Primary robotic RLPND for nonseminomatous germ cell testicular cancer: a two-center analysis of intermediate oncologic and safety outcomes

Management of low-risk prostate cancer in patients with enlarged glands and lower urinary tract symptoms: robotic total prostatectomy, a novel technique