Department of Urology, University of Toledo Medical Center, Toledo, Ohio 43614, USA.
J Endourol. 2009 Dec;23(12):2047-50. doi: 10.1089/end.2009.0112.
To use a validated questionnaire to compare indwelling ureteral stent symptoms in patients who had the ureteral stent placed during renal transplantation with patients who had retrograde insertion of the stent in a native kidney during endoscopic procedures.
Symptoms related to the presence of a ureteral stent were assessed prospectively in the two patient groups. Just before stent removal, patients completed a validated Ureteral Stent Symptom Questionnaire evaluating urinary symptoms, body pain, general health, work performance, and sexual function. Categorical scores and individual factors were qualitatively and statistically compared between the two groups.
Twenty-eight (15 men and 13 women) patients (mean age 56, range 72-32) underwent renal transplantation with ureteral stents removed after a mean of 41 days (range 9-81). Seventeen (4 men and 13 women) patients (mean age 43, range 73-17) had ureteral stents placed in native kidneys for other indications with subsequent removal after a mean of 24 days (range 6-61). The transplant group had statistically fewer urinary symptoms (p = 0.001), pain symptoms (p < 0.001), better overall health index (p = 0.005), and improved quality of work (p = 0.008). Transplant patients complained of fewer urinary symptoms (urgency, dysuria, dribbling, and hematuria), required less additional antibiotic use, and had fewer additional clinic or hospital visits.
Ureteral stents inserted during renal transplantation result in significantly fewer symptoms when compared with stents inserted in the native ureter. This, in part, may be because of less trigonal irritation by the stent when the ureteral implantation is in the dome of the bladder.
使用经过验证的问卷比较接受经肾移植时留置输尿管支架的患者与接受内镜手术时逆行插入原生肾输尿管支架的患者的支架相关症状。
前瞻性评估两组患者存在输尿管支架相关症状。在支架取出前，患者完成了一份经过验证的输尿管支架症状问卷，评估了尿症状、身体疼痛、一般健康状况、工作表现和性功能。定性评分和个体因素在两组之间进行了定性和统计学比较。
28 例（15 名男性和 13 名女性）患者（平均年龄 56 岁，范围 72-32 岁）接受了肾移植，输尿管支架在平均 41 天后（范围 9-81 天）取出。17 例（4 名男性和 13 名女性）患者（平均年龄 43 岁，范围 73-17 岁）因其他适应症在原生肾中放置了输尿管支架，随后在平均 24 天后（范围 6-61 天）取出。移植组的尿症状（p = 0.001）、疼痛症状（p < 0.001）、整体健康指数（p = 0.005）和工作质量（p = 0.008）均有统计学上的显著改善。移植患者抱怨的尿症状（尿急、尿痛、滴沥和血尿）更少，需要更少的额外抗生素使用，并且需要更少的额外就诊或住院。
与在原生输尿管中插入支架相比，在肾移植时插入输尿管支架会导致明显较少的症状。这在一定程度上可能是由于支架在膀胱穹窿处植入时对三角区的刺激较小。
