Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Can J Urol. 2021 Feb;28(1):10516-10521.
INTRODUCTION To assess the relationship between pain after ureteral stent removal and patient and procedural factors.
A validated survey designed to assess the relationship between quality of life and treatment decisions in kidney stone disease was randomly distributed to patients with a history of a ureteral stent in seven medical centers across North America participating in an endourology research collaborative between July 2016 and June 2018. The primary outcome was increased pain after ureteral stent removal. Statistical analyses were performed using Chi-square and multiple logistic regression.
A total of 327 surveys were analyzed. Twenty seven percent of patients reported increased pain in the hours after ureteral stent removal. Patients with a stent ≤ 7 days were significantly more likely to experience pain after stent removal compared to those with a stent > 7 days (33.3% versus 22.8%, p = 0.04). Female gender (OR: 2.41, 95% CI: 1.42-4.10) was associated with increased pain after stent removal, while increasing age was inversely associated (OR: 0.52, 95% CI: 0.36-0.74). After adjustment, patients with a stent > 7 days were significantly less likely to report pain in the hours after removal (OR: 0.59, 95% CI: 0.35-0.99).
Approximately one in four patients will experience increased pain after ureteral stent removal. Female patients, younger patients, and patients with a stent ≤ 7 days were more likely to experience an increase in pain immediately following stent removal. Understanding factors associated with post-stent removal pain may be helpful in counseling patients at high risk stent removal morbidity.
评估输尿管支架取出后疼痛与患者和操作因素的关系。
本研究采用经过验证的调查问卷，评估了北美 7 家医学中心的 327 例接受过输尿管支架置入术的患者在 2016 年 7 月至 2018 年 6 月期间参与腔内泌尿外科研究协作组时的生活质量与治疗决策之间的关系。主要结局是输尿管支架取出后疼痛增加。采用卡方检验和多因素逻辑回归进行统计学分析。
27%的患者报告在输尿管支架取出后数小时内疼痛加重。支架留置时间≤7 天的患者与支架留置时间>7 天的患者相比，更有可能出现支架取出后疼痛（33.3%比 22.8%，p=0.04）。女性（OR：2.41，95%CI：1.42-4.10）与支架取出后疼痛增加相关，而年龄增加则与之相反（OR：0.52，95%CI：0.36-0.74）。校正后，支架留置时间>7 天的患者在取出后数小时内报告疼痛的可能性明显降低（OR：0.59，95%CI：0.35-0.99）。
约四分之一的患者在输尿管支架取出后会出现疼痛加重。女性、年轻患者和支架留置时间≤7 天的患者在支架取出后立即出现疼痛增加的可能性更高。了解与支架取出后疼痛相关的因素可能有助于对高风险支架取出并发症的患者进行咨询。
