Forbes Connor M, Chew Ben H, Wong K F Victor, Ren Runhan, Ji Yuanyuan, Glaser Alexander P, Taguchi Kazumi, Krambeck Amy E, Rivera Marcelino E, Shah Ojas, Tariel Edouard, Amarasekera Channa, Hamamoto Shuzo, Lange Dirk, Molina Wilson R, Knoedler John J, Humphreys Mitchell R, Stern Karen L
Department of Urology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.
Division of Biostatistics, Boston Scientific Corporation, Marlborough, MA 01752, USA.
Can J Urol. 2025 Aug 29;32(4):335-344. doi: 10.32604/cju.2025.063577.
Previous studies have shown conflicting results concerning the optimal duration of ureteral stenting after endourologic treatment of stone disease, its effect on patient comfort, and the necessity for emergent, unscheduled care. This study assessed the impact of stent duration, sex, and other patient-associated factors on reported pain scores using a large, international prospective registry.
A prospective observational patient registry on ureteral stents from 10 institutions in 4 countries (United States, Canada, France, and Japan) from 2020-2023 was assessed. The primary outcome was Patient-Reported Outcomes Measurement Information System (PROMIS) pain intensity scores administered on the day of stent removal, before stent removal. Patients were grouped by indwelling time (short, medium, and long), and pain scores were compared. The impact of sex, height vs. stent length, and presence or absence of tether were assessed.
359 patients were enrolled in the database, with outcomes analyzed for 268 patients with a unilateral stent placed after an endourologic procedure for stones. No significant difference was detected in pain scores between the indwelling time groups (p = 0.41). Height for a given stent length was not significantly associated with pain scores. There was no difference in pain scores with or without tether. Men reported lower pain scores than women (p = 0.018).
This study did not detect an overall difference in pain scores reported at stent removal within or between stent duration groups. Men reported less pain than women in this study, suggesting that patient factors may be more important than indwelling time when optimizing pain management.
既往研究对于结石病腔内治疗后输尿管支架置入的最佳时长、其对患者舒适度的影响以及急诊、非计划护理的必要性呈现出相互矛盾的结果。本研究使用一个大型国际前瞻性注册数据库评估了支架置入时长、性别及其他患者相关因素对报告的疼痛评分的影响。
对2020年至2023年来自4个国家（美国、加拿大、法国和日本）10家机构的输尿管支架前瞻性观察患者注册数据库进行评估。主要结局指标是在支架取出当天、取出前进行的患者报告结局测量信息系统（PROMIS）疼痛强度评分。患者按留置时间分组（短、中、长），并比较疼痛评分。评估了性别、身高与支架长度的关系以及是否有固定装置的影响。
359例患者纳入数据库，对268例腔内结石手术后置入单侧支架的患者的结局进行分析。留置时间组间疼痛评分未检测到显著差异（p = 0.41）。对于给定的支架长度，身高与疼痛评分无显著相关性。有无固定装置的疼痛评分无差异。男性报告的疼痛评分低于女性（p = 0.018）。
本研究未检测到支架持续时间组内或组间在支架取出时报告的疼痛评分存在总体差异。本研究中男性报告的疼痛比女性少，这表明在优化疼痛管理时，患者因素可能比留置时间更重要。
