Size does matter: ureteral stents with a smaller diameter show advantages regarding urinary symptoms, pain levels and general health

World J Urol. 2020 Apr;38(4):1059-1063. doi: 10.1007/s00345-019-02829-0. Epub 2019 May 31.

Abstract

Objective: To compare the effect of different diameters of ureteral stents (F4.7, F6, and F7) on quality of life regarding the subdomains of the Ureteral Stent Symptom Questionnaire.

Materials and methods: All patients undergoing URS between April 2016 and July 2017 were prospectively randomised for ureteral stents F4.7, F6 and F7, respectively. All patients with other pathologies than a ureter stone, ureteral stents on both sides or other therapy than a secondary URS were excluded. Readmitted patients were interviewed using the USSQ. Furthermore, success rates of the second URS were also noted.

Results: Between April 2016 to July 2017, 181 patients were included, 48 with a ureteral stent F4.6, 66 with F6 and 67 with F7. No significant differences in age, gender or position of the stones before URS were found (all p > 0.5). Comparing scores of USSQ between F4.7 and F6 or F6 and F7, scores were in favour of the smaller stent, but significance was only reached in "Work performance score" (F6-F7, p = 0.04) and "Urinary index score" (F4.7-F6, p = 0.004). When comparing F4.7 with F7, significant differences in all subgroups in favour of F4.7 were documented (all p < 0.03). Surgical success of the second URS was comparable in all groups (all above 82%, p > 0.15).

Conclusion: Discomfort and pain increase with the diameter of the indwelling ureter stent, while the success of the following URS is not compromised by a ureter stent with a smaller diameter. Therefore, ureteral stents with a small diameter should be preferred.

Keywords: Stent-related pain; USSQ; Ureter stents; Ureterorenoscopy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Diagnostic Self Evaluation
  • Equipment Design
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / etiology*
  • Postoperative Complications / etiology*
  • Prospective Studies
  • Quality of Life
  • Single-Blind Method
  • Stents / adverse effects*
  • Ureteral Calculi / surgery*
  • Ureteroscopy*