Al-Kandari Ahmed M, Al-Shaiji Tariq F, Shaaban Hani, Ibrahim Hamdy M, Elshebiny Yehya H, Shokeir Ahmed A
Urology Unit, Adan Hospital, Kuwait., Department of Surgery, Kuwait University, Kuwait.
J Endourol. 2007 Jul;21(7):698-702. doi: 10.1089/end.2007.9949.
To evaluate the effect of the position of the proximal and distal ends of Double-J ureteral stents on postprocedural flank pain, lower urinary-tract symptoms, and quality of life.
The study included 120 patients who required unilateral Double-J ureteral stents for various indications. They were randomized into two equal groups. Group 1 had longer stents, with the proximal end in the upper calix and the distal end crossing the midline of the bladder. Group 2 had proper stent length with the proximal end in the pelvis and the lower end just beyond the vesicoureteral junction. Patients answered a questionnaire regarding flank pain, dysuria, and urgency as well as quality of life after 1 week of stenting.
Forty patients (67%) of group 1 and 43 (72%) of group 2 had mild flank pain, especially during urination. There was no significant difference in the degree of flank pain in the two groups. Moderate to severe dysuria was reported by 53 patients (88%) in group 1 and 11 patients (18%) in group 2 (P < 0.001). Moderate to severe urgency was reported by 48 patients (80%) in group 1 and in 14 (23%) in group 2 (P < 0.001). A worse quality of life was reported by patients in group 1, among whom moderate to severe bother was noted by 51 (85%) compared with group 2, in which moderate to severe bother was reported by only 13 patients (22%) (P < 0.001).
Ureteral stents are associated with flank pain and lower urinary-tract symptoms. The flank pain was not affected by the length of stent. Urgency and dysuria as well as a worse quality of life were significantly more common in the patients who had longer stents.
评估双J输尿管支架近端和远端位置对术后胁腹疼痛、下尿路症状及生活质量的影响。
本研究纳入120例因各种适应证需要单侧双J输尿管支架的患者。他们被随机分为两组，每组人数相等。第1组使用较长的支架，近端位于上肾盏，远端越过膀胱中线。第2组使用长度合适的支架，近端位于盆腔，远端刚好位于膀胱输尿管连接处之外。患者在置入支架1周后回答了一份关于胁腹疼痛、排尿困难、尿急以及生活质量的问卷。
第1组40例患者（67%）和第2组43例患者（72%）有轻度胁腹疼痛，尤其是在排尿时。两组胁腹疼痛程度无显著差异。第1组53例患者（88%）报告有中度至重度排尿困难，第2组11例患者（18%）报告有中度至重度排尿困难（P<0.001）。第1组48例患者（80%）报告有中度至重度尿急，第2组14例患者（23%）报告有中度至重度尿急（P<0.001）。第1组患者报告生活质量较差，其中51例（85%）有中度至重度困扰，而第2组只有13例患者（22%）报告有中度至重度困扰（P<0.001）。
输尿管支架与胁腹疼痛和下尿路症状有关。胁腹疼痛不受支架长度影响。尿急、排尿困难以及较差的生活质量在使用较长支架的患者中明显更为常见。
