Ureteral stent related symptoms: A comparative study

Themistoklis Ch. Bellos; Ioannis S. Manolitsis; Stamatios N. Katsimperis; Panagiotis A. Angelopoulos; Sotirios G. Kapsalos-Dedes; Panagiotis K. Deligiannis; Lazaros I. Tzelves; Nikolaos A. Kostakopoulos; Iraklis C. Mitsogiannis; Ioannis M. Varkarakis; Athanasios G. Papatsoris; Andreas A. Skolarikos; Charalampos N. Deliveliotis

doi:10.4081/aiua.2024.12231

Authors

Themistoklis Ch. Bellos
bellos.themistoklis@gmail.com
2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece. https://orcid.org/0000-0002-0390-1467
Ioannis S. Manolitsis 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Stamatios N. Katsimperis 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Panagiotis A. Angelopoulos 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Sotirios G. Kapsalos-Dedes 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Panagiotis K. Deligiannis 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Lazaros I. Tzelves 1st Department of Urology, Metropolitan General, Cholargos, Greece.
Nikolaos A. Kostakopoulos 1st Department of Urology, Metropolitan General, Cholargos, Greece.
Iraklis C. Mitsogiannis 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Ioannis M. Varkarakis 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Athanasios G. Papatsoris 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Andreas A. Skolarikos 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.
Charalampos N. Deliveliotis 2nd Department of Urology, Sismanoglio General Hospital of Athens, Greece.

Background: In urology, ureteral stents are used to treat obstructive diseases. Hematuria (54%), fever, discomfort, and lower urinary system symptoms are the predominant symptoms related to ureteral stent.
Aim: This article links stent symptoms to double-j width and length, as well as patient’s height, weight, and body mass index (BMI). Ureteric Stent Symptoms Questionnaire (USSQ) was used to measure ureteral stent symptoms at 1^st and 4^th week of stent in situ as well as the 4^th week after pigtail removal.
Methods: A 200-patient prospective study, where patients were allocated into four groups following ureteral stent insertion depending on the stent characteristics. Those groups were: 4.8 Fr./26 cm (Group A), 4.8 Fr./28 cm (Group B), 6 Fr/26 cm (Group C), and 6 Fr/28 cm (Group D).
Results: Men comprised 53.5% of 200 patients. Participants had an average age of 49 ± 15.5 years, height of 175 ± 8.94 cm, and BMI of 23.8 ± 7.6 cm. The laboratory results were identical between groups. At the first and fourth week, groups had similar urine symptoms, pain severity, health status and occupational activities. The difference in pain location was statistically significant. Group A had 82.4% renal back pain in the first week, whereas Group B had 68.8%, Group C 31.3% and Group D 62.5 (p=0.04). At the fourth week, 64.7% of Group A patients reported kidney front pain, compared to 100% of Group B, 93.3% of Group C, and 100% of Group D (p=0.04). There was statistical significance in the sexual activity of the patients. 24.4% of Group C patients stopped sexual activity before stent installation, compared to 10.6%, 8.3%, and 6.4% of the other groups (p=0.03). A moderate percentage of patients had active sexual activity at week 4 (Group A: 7.8%, Group B: 5.8%, Group C: 8.2%, Group D: 4.1%), p=0.83. In multivariate analysis, urinary catheter group, age, weight, height, and BMI did not significantly affect urine index score (UIS), pain index score (PIS), general health (GH), quality of work (QW), and quality of sex (QS).
Conclusions: Despite various attempts to establish the best ureteral stent, the effect of double-j stent physical features on stent-related symptoms remained unknown. No verdict is conceivable without adequate empirical data.

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Bellos, T. C., Manolitsis, I. S., Katsimperis, S. N., Angelopoulos, P. A., Kapsalos-Dedes, S. G., Deligiannis, P. K., Tzelves, L. I., Kostakopoulos, N. A., Mitsogiannis, I. C., Varkarakis, I. M., Papatsoris, A. G., Skolarikos, A. A., & Deliveliotis, C. N. (2024). Ureteral stent related symptoms: A comparative study. Archivio Italiano Di Urologia E Andrologia, 96(1). https://doi.org/10.4081/aiua.2024.12231