Ureteral stent related symptoms: A comparative study

Submitted: December 25, 2023
Accepted: December 29, 2023
Published: March 4, 2024
Abstract Views: 350
PDF: 133
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


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 1st and 4th week of stent in situ as well as the 4th 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.

Finney RP. Experience with new double J ureteral catheter stent. J Urol 1978; 120:678-81. DOI: https://doi.org/10.1016/S0022-5347(17)57326-7

Hepperlen TK, Mardis HK. Pigtail stent termed means of lessening ureteral surgery. Trends Clin Urol 1978;1:405.

Beiko DT, Knudsen BE, Denstedt JD. Advances in ureteral stent design. J Endourol 2003;17:195-9. DOI: https://doi.org/10.1089/089277903765444294

Marmar JL. The management of ureteral obstruction with silicone rubber splint catheters. J Urol 1970;104:386-9. DOI: https://doi.org/10.1016/S0022-5347(17)61744-0

Orikasa S, Tsuji I, Siba T, Oashi N. A new technique for transurethral insertion of a silicone rubber tube into an obstructed ureter. J Urol 1973;110:184-7. DOI: https://doi.org/10.1016/S0022-5347(17)60154-X

McCullough JL. Shepards Crook self-retaining ureteral catheter. Urol Lett Club 1974;32:54-5.

Joshi HB, Newns N, Stainthorpe A, et al. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol. 2003;169:1060-4. DOI: https://doi.org/10.1097/01.ju.0000049198.53424.1d

Centers fors Disease Control and Prevention. Body mass index (BMI). Available from: https://www.cdc.gov/healthyweight/assessing/bmi/index.html

Dellis A, Joshi HB, Timoney AG, Keeley FX Jr. Relief of stent related symptoms: Review of engineering and pharmacological solutions. J Urol 2010; 184:1267-72. DOI: https://doi.org/10.1016/j.juro.2010.06.043

Raju T. Indwelling ureteral stents: Impact of material and shape in patient comfort. J Endourol 2009;7:2.

Vogt B, Desgrippes A, Desfemmes FN. Changing the double-pigtail stent by a new suture stent to improve patient's quality of life: A prospective study. World J Urol 2015;33:1061-8. DOI: https://doi.org/10.1007/s00345-014-1394-2

Ahallal Y, Khallouk A, El Fassi MJ, Farih MH. Risk factor analysis and management of ureteral double-j stent complications. Rev Urol 2010;12:e147-51.

Giannarini G, Keeley FX Jr, Valent F, et al. Predictors of morbidity in patients with indwelling ureteric stents: Results of a prospective study using the validated ureteric stent symptoms questionnaire. BJU Int 2011; 107:648-54. DOI: https://doi.org/10.1111/j.1464-410X.2010.09482.x

Bolat MS, Akdeniz E, Asci R, et al. Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomized prospective study. Andrologia 2017;49:e12746. DOI: https://doi.org/10.1111/and.12746

Sighinolfi MC, Micali S, De Stefani S, et al. Indwelling ureteral stents and sexual health: A prospective, multivariate analysis. J Urol 2007; 178:229-31. DOI: https://doi.org/10.1016/j.juro.2007.03.039

Al-Kandari AM, Al-Shaiji TF, Shaaban H, et al. Effects of proximal and distal ends of double-J ureteral stent position on postprocedural symptoms and quality of life: A randomized clinical trial. J Endourol 2007;21:698-702. DOI: https://doi.org/10.1089/end.2007.9949

Inn FX, Ahmed N, Hou LG, et al. Intravesical stent position as a predictor of quality of life in patients with indwelling ureteral stent. Int Urol Nephrol 2019;51:1949-53. DOI: https://doi.org/10.1007/s11255-019-02262-7

Ho CH, Tai HC, Chang HC, et al. Predictive factors for ureteral double-J-stent-related symptoms: A prospective, multivariate analysis. J Formos Med Assoc 2010; 109:848-56. DOI: https://doi.org/10.1016/S0929-6646(10)60130-1

Abt D, Mordasini L, Warzinek E, et al. Is intravesical stent positiona predictor of associated morbidity? Korean J Urol 2015; 56:370-8. DOI: https://doi.org/10.4111/kju.2015.56.5.370

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


Download data is not yet available.