Lim Kheng Sit, Law Zhi Wei, Chow Marcus Way Lunn, Sim Allen Soon Phang, Ho Henry Sun Sien
Department of Urology, Singapore General Hospital, Singapore.
Department of Urology, Tan Tock Seng Hospital, Singapore.
Asian J Urol. 2020 Oct;7(4):357-362. doi: 10.1016/j.ajur.2019.09.004. Epub 2019 Sep 30.
The Polaris™ loop ureteric stent reduces the severity of stent discomfort by minimising stent material in the bladder. Early impact of ureteral stenting on quality of life (QoL) within 1 week remains unclear. The usefulness of the patient-administered ureteral stent symptoms questionnaire (USSQ) during this period of stent insertion was assessed. In this pilot single-blinded prospective randomised study, we investigate 1) the presence of early (within the 1st week) stent discomfort via the visual analog scale (VAS); 2) determine the QoL of the loop stent against conventional stent.
Forty adults requiring retrograde unilateral ureteral stent placements were enrolled. Patients with single ureteric stone or benign stricture were selected. Patients were randomised in 1:1 ratio to the loop and pigtail arm. The USSQ was administered before placement (baseline), USSQ and VAS were administered on Day 3, 7, and 14.
There were no significant differences between the USSQ scores. Median pain scores on Day 3 were lower in the loop stent group (2.9 4.0, =0.047). There was a significant reduction in pain from Day 3-7 (0 -1, =0.016) in the pigtail group.
Our results suggest that peak stent discomfort occurs but resolves quickly within 1 week of post-stent insertion. The loop stent offers a better pain profile compared with conventional stents at Day 3 but no difference in QoL. The loop stent reduces early pain experience post-stent insertion and may have a role in the care of patients who experience significant stent discomfort previously.
北极星™环形输尿管支架通过减少膀胱内的支架材料来减轻支架不适的严重程度。输尿管支架置入术后1周内对生活质量(QoL)的早期影响尚不清楚。评估了患者自行填写的输尿管支架症状问卷(USSQ)在支架置入期间的有用性。在这项单盲前瞻性随机对照试验中,我们研究了:1)通过视觉模拟量表(VAS)评估早期(第1周内)支架不适的情况;2)确定环形支架与传统支架相比的生活质量。
纳入40例需要逆行单侧输尿管支架置入的成年人。入选患有单发性输尿管结石或良性狭窄的患者。患者按1:1比例随机分为环形支架组和猪尾形支架组。在放置前(基线)进行USSQ评估,在第3、7和14天进行USSQ和VAS评估。
USSQ评分之间无显著差异。环形支架组第3天的中位疼痛评分较低(2.9对4.0,P=0.047)。猪尾形支架组第3至7天的疼痛有显著减轻(0对-1,P=0.016)。
我们的结果表明,支架不适的峰值出现在支架置入后1周内,但会迅速缓解。与传统支架相比,环形支架在第3天的疼痛情况更好,但生活质量无差异。环形支架可减轻支架置入后的早期疼痛,对于之前经历过严重支架不适的患者护理可能有作用。