A randomized trial investigating clinical outcomes and stent-related symptoms after placement of a complete intra-ureteric stent on a string versus conventional stent placement.

OBJECTIVE

To compare stent-related symptoms (SRS) associated with conventional ureteric JJ stent (CUS) placement and SRS associated with placement of a modified complete intra-ureteric stent (CIUS) with extraction suture, designed to minimize SRS, using the validated Ureteral Stent Symptom Questionnaire (USSQ).

MATERIALS AND METHODS

We randomized 124 patients who had undergone uncomplicated ureteroscopic lithotripsy into a CIUS and a CUS placement group. USSQ scores were evaluated on postoperative days 1 and 7 (just before stent removal) and 4 weeks after stent removal (control values). Pain scores on a visual analogue scale (VAS) after stent removal were also recorded. Subdomain analysis of all SRS and stent-related complications were also compared.

RESULTS

No significant intergroup differences were found in the domain scores for urinary symptoms (P = 0.74), pain (P = 0.32), general health (P = 0.27), work (P = 0.24), or additional problems (P = 0.29). However, a statistically significant difference was noted in VAS scores (P = 0.015). Analysis of subdomains of USSQ item scores showed the CIUS group had significantly better scores for urge incontinence (1.21 vs 1.00; P ≤ 0.001), discomfort on voiding (2.07 vs 1.50; P ≤ 0.001), difficulties with respect to light physical activity (1.131 vs 1.00; P ≤ 0.001), fatigue (1.84 vs 1.57; P = 0.002), feeling comfortable (3.68 vs 3.16; P = 0.003), need for extra help (1.96 vs 1.00; P ≤ 0.001), and change in duration of work (4.27 vs 1.86; P ≤ 0.001). However, the patients in the CIUS group were sexually inactive for the time during which the stent was indwelling (mean: 7.34 days). There was no difference in complication rates between the two groups.

CONCLUSION

The use of a CIUS with strings after Ureteroscopy decreases SRS.