Abt Dominik, Mordasini Livio, Warzinek Elisabeth, Schmid Hans-Peter, Haile Sarah Roberta, Engeler Daniel Stephan, Müllhaupt Gautier
Department of Urology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland.
Clinical Trials Unit, St. Gallen Cantonal Hospital, St. Gallen, Switzerland.
Korean J Urol. 2015 May;56(5):370-8. doi: 10.4111/kju.2015.56.5.370. Epub 2015 Apr 24.
Temporary drainage of the upper urinary tract by use of internal ureteral stents is a common procedure that is often associated with a variety of symptoms. The role of intravesical stent position in associated morbidity is controversial.
The German version of the ureteral stent symptom questionnaire (USSQ) was completed by 73 patients with an indwelling ureteral stent the day before stent removal. Intravesical stent position was classified into 3 categories by x-ray before stent removal. The influence of intravesical stent position on USSQ score was analyzed, including subscores and single items.
Intravesical stent position showed no significant influence on associated morbidity. The median USSQ total score in all patients was 77.5 (range, 30-147). Patients with ipsilateral stents (69.0; range, 30-122) tended to have lower total scores than did those with tangential (86.5; range, 30-122) or contralateral (77.0; range, 31-147) stents, but the differences were not statistically significant (p=0.35). The USSQ subscores for urinary symptoms (p=0.80), body pain (p=0.80), general health (p=0.16), work performance (p=0.07), additional problems (p=0.81), and all of the USSQ single items of interest in the context of stent length also did not differ significantly between the three groups.
Intravesical stent position did not significantly influence associated morbidity in our study. An appropriate stent length should be chosen to avoid dislocation. However, complex calculations of optimum stent length, time-consuming manipulations, and costly stock holding of various stent sizes to obtain the perfect stent position do not seem worthwhile.
使用输尿管内支架对上尿路进行临时引流是一种常见的操作，常伴有多种症状。膀胱内支架位置在相关发病率中的作用存在争议。
73例留置输尿管支架的患者在支架取出前一天完成了输尿管支架症状问卷（USSQ）德文版。在支架取出前通过X线将膀胱内支架位置分为3类。分析膀胱内支架位置对USSQ评分的影响，包括子评分和单项评分。
膀胱内支架位置对相关发病率无显著影响。所有患者的USSQ总评分中位数为77.5（范围30 - 147）。同侧支架患者（69.0；范围30 - 122）的总评分往往低于切线位（86.5；范围30 - 122）或对侧（77.0；范围31 - 147）支架患者，但差异无统计学意义（p = 0.35）。三组间在泌尿症状（p = 0.80）、身体疼痛（p = 0.80）、总体健康（p = 0.16）、工作表现（p = 0.07）、其他问题（p = 0.81）的USSQ子评分以及在支架长度方面所有感兴趣的USSQ单项评分也无显著差异。
在我们的研究中，膀胱内支架位置对相关发病率无显著影响。应选择合适的支架长度以避免移位。然而，为获得理想的支架位置而进行复杂的最佳支架长度计算、耗时的操作以及储存各种支架尺寸的高昂成本似乎并不值得。
