Effect of ureteral stent diameter on ureteral stent‐related symptoms. Issue 4 (7th April 2019) - Taguchi, Makoto
Abstract : Objective: This study investigated the correlation between ureteral stent diameter and stent‐related symptoms. Methods: This study evaluated 17 patients (53 [74.6%] men, 18 [25.4%] women; mean [±SD] age 59.3 ± 14.2 years) who underwent ureteral stent placement before ureteroscopic lithotripsy (URSL) and in whom the ureteral stent tail was positioned inside the bladder without crossing the midline. All stents were Inlay Optima stents. Stent diameter (6 or 4.7 Fr) and length (24 or 26 cm) were chosen at the surgeon's discretion. Patients were classified into two groups (Group 1, 6‐Fr stent; Group 2, 4.7‐Fr stent). Urinary symptoms before insertion of the ureteral stents and the day before URSL were assessed using the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS). In addition, patient background and changes in the IPSS and OABSS were compared. Factors affecting ureteral stent‐related symptoms were evaluated using multivariate analysis. Results: Compared with Group 2, Group 1 had a worse total IPSS ( P = 0.02), as well as intermittency ( P = 0.009), urgency ( P = 0.008), voiding symptoms (Q1 + Q3 + Q5 + Q6; P = 0.046), and storage symptoms (Q2 + Q4 + Q7; P = 0.017) subscores on the IPSS, total OABSS ( P = 0.045) and OABSS urgency subscore ( P = 0.002). Multivariate analysis revealed that stent diameter was significantly associated with total IPSS ( P = 0.007) and OABSS ( P = 0.036). Conclusion: This is the first study to show that larger‐diameter ureteral stents induce significantly worse urinary symptoms. Ureteral stents with smaller diameters are recommended to improve ureteral stent‐related symptoms.