Comparison of Ureteral Stents-Related Symptoms among Patients with Ureteral Stents of 4.7Fr and 6Fr Diameter: Patients with Ureteral Stents of 4.7Fr and 6Fr Diameter

Muhammad Zahid Ahmad; Abdul Rehman; Muhammad Asif; Abdul Basit Niaz; Rao Nouman Ali; Shafqat Shahzad

doi:10.54393/pjhs.v6i12.2769

Authors

Muhammad Zahid Ahmad Department of Urology, King Edward Medical University, Lahore, Pakistan
Abdul Rehman Department of Urology, King Edward Medical University, Lahore, Pakistan
Muhammad Asif Department of Urology, King Edward Medical University, Lahore, Pakistan
Abdul Basit Niaz Naizi Medical and Dental College, Lahore, Pakistan
Rao Nouman Ali Department of Urology, District Headquarters Hospital, Khanewal, Pakistan
Shafqat Shahzad Department of Biostatistics, University of Punjab, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i12.2769

Keywords:

IPSS Score, Ureteral Stent-Related Symptoms, Double J Stent, 4.7Fr and 6Fr Diameters

Abstract

Ureteric stents are essential in urology, but factors like diameter, position, and design can significantly impact patients' quality of life. Objectives: To compare the mean IPSS scores among patients with ureteral stents of 4.7Fr and 6Fr diameter. Methods: The quasi-experimental study was conducted at the Department of Urology and Renal Transplant, Mayo Hospital, Lahore, from March to September 2024. 124 patients were selected for this study who required DJ Stenting after open or endourological surgery. Patients were categorized into two groups. Each group contains 62 patients. All patients underwent open or endourological surgery followed by DJ Stenting as indicated. 4.7 Fr DJ Stents were placed in Group A and 6 Fr DJ Stents in Group B. Results: A Total of 124 patients, the mean age of the 4.7 Fr DJ stent group was 47.88 ± 6.56 years, and 49.48 ± 6.57 years in the 6 Fr DJ stent group. The p-value = 0.178, duration of operation 50.85 ± 0.64 minutes in group A and 55.25 ± 0.76 minutes in group B. The p-value = 0.000). There were 43 (55.1%) male and 19 (41.3%) female in group A, and 35 (44.9%) male and 27 (58.7%) female in group B. A (p=0.193) IPSS score was 2.21 ± 0.11 in group A and 6.33 ± 0.19 in group B (p=0.000). Conclusions: It was concluded that ureteral stents with larger diameters result in notably more severe urinary symptoms. It is advisable to use ureteral stents with smaller diameters to alleviate symptoms related to stent use.

References

Mburu JK. Indications and early complications of double–J ureteric stents as seen at Kenyatta national hospital (Doctoral dissertation, University of Nairobi). 2020.

Bilotta A, Wiegand LR, Heinsimer KR. Ureteral reconstruction for complex strictures: a review of the current literature. International Urology and Nephrology. 2021 Nov: 1-9. doi: 10.1007/s11255-021-02985-6.

Zheng S, Carugo D, Mosayyebi A, Turney B, Burkhard F, Lange D et al. Fluid mechanical modeling of the upper urinary tract. Wiley Interdisciplinary Reviews: Mechanisms of Disease. 2021 Nov; 13(6): e1523. doi: 10.1002/wsbm.1523.

Goetz LL and Klausner AP. Neurogenic Lower Urinary Tract Dysfunction. In Braddom's Physical Medicine and Rehabilitation. 2021 Jan: 389-406. doi: 10.1016/B978-0-323-62539-5.00020-5.

Bosio A, Alessandria E, Agosti S, Vitiello F, Vercelli E, Bisconti A et al. Pigtail suture stents significantly reduce stent-related symptoms compared to conventional double J stents: a prospective randomized trial. European Urology Open Science. 2021 Jul; 29: 1-9. doi: 10.1016/j.euros.2021.03.011.

Anderson B, Heiman JM, Krambeck A. Quality of Life After Ureteroscopy. Ureteroscopy: A Comprehensive Contemporary Guide. 2020: 123-39. doi: 10.1007/978-3-030-26649-3_10.

Diatmika AA, Djojodimedjo T, Kloping YP, Hidayatullah F, Soebadi MA. Comparison of ureteral stent diameters on ureteral stent-related symptoms: A systematic review and meta-analysis. Turkish Journal of Urology. 2022 Jan; 48(1): 30. doi: 10.5152/tud.2022.21255.

Hinojosa-Gonzalez DE, Saffati G, Kronstedt S, Link RE, Mayer WA. Complete Intraureteral Stents Decrease Urinary Symptoms Compared with Conventional Ureteral Stents: A Systematic Review and Meta-Analysis. Journal of Endourology. 2024 Feb; 38(2): 198-204. doi: 10.1089/end.2023.0467.

Reddy SJ, Reddy BS, Chawla A, de la Rosette JJ, Laguna P, Hegde P et al. Outcomes and complications from a randomized controlled study comparing conventional stent placement versus no stent placement after ureteroscopy for distal ureteric calculus< 1 cm. Journal of Clinical Medicine. 2022 Nov; 11(23): 7023. doi: 10.3390/jcm11237023.

Bosio A, Ferretti S, Alessandria E, Vitiello F, Vercelli E, Campobasso D et al. Patients undergoing double J substitution with a pigtail suture stent report a significant decrease of stent-related symptoms. Results from a prospective multicenter longitudinal trial. World Journal of Urology. 2024 Mar; 42(1): 186. doi: 10.1007/s00345-024-04879-5.

Taguchi M, Yasuda K, Kinoshita H. Prospective randomized controlled trial comparing a ureteral stent crossing versus not crossing the bladder midline. World Journal of Urology. 2022 Jun; 40(6): 1537-43. doi: 10.1007/s00345-022-03978-5.

Wiseman O, Ventimiglia E, Doizi S, Kleinclauss F, Letendre J, Cloutier J et al. Effects of silicone hydrocoated double loop ureteral stent on symptoms and quality of life in patients undergoing flexible ureteroscopy for kidney stone: a randomized multicenter clinical study. The Journal of Urology. 2020 Oct; 204(4): 769-77. doi: 10.1097/JU.0000000000001098.

Ehsanullah SA, Bruce A, Juman C, Krishan A, Krishan A, Higginbottom J et al. Stent diameter and stent-related symptoms, does size matter? A systematic review and meta-analysis. Urology Annals. 2022 Oct; 14(4): 295-302. doi: 10.4103/ua.ua_158_21.

Harper JD, Desai AC, Antonelli JA, Tasian GE, Ziemba JB, Al-Khalidi HR et al. Quality of life impact and recovery after ureteroscopy and stent insertion: insights from daily surveys in STENTS. BioMed Central Urology. 2022 Apr; 22(1): 53. doi: 10.1186/s12894-022-01004-9.

Ganguly A, Tyagi S, Chermansky C, Kanai A, Beckel J, Hashimoto M et al. Treating Lower Urinary Tract Symptoms in Older Adults: Intravesical Options. Drugs and Aging. 2023 Mar; 40(3): 241-61. doi: 10.1007/s40266-023-01009-5.

Pecoraro A, Peretti D, Tian Z, Aimar R, Niculescu G, Alleva G et al. Treatment of ureteral stent-related symptoms. Urologia Internationalis. 2023 Mar; 107(3): 288-303. doi: 10.1159/000518387.

Van Besien J, Keller EX, Somani B, Pietropaolo A, Claessens M, Merckx L et al. Mirabegron for the treatment of ureteral stent-related symptoms: a systematic review and meta-analysis. European Urology Focus. 2022 Jul; 8(4): 1031-41. doi: 10.1016/j.euf.2021.10.002.

Nestler S, Witte B, Schilchegger L, Jones J. Size does matter: ureteral stents with a smaller diameter show advantages regarding urinary symptoms, pain levels and general health. World Journal of Urology. 2020 Apr; 38(4): 1059-63. doi: 10.1007/s00345-019-02829-0.

Vishnu J, Manivasagam G, Mantovani D, Udduttula A, Coathup MJ, Popat KC et al. Balloon expandable coronary stent materials: a systematic review focused on clinical success. In Vitro Models. 2022 Apr; 1(2) :151-75. doi: 10.1007/s44164-022-00009-w.

Butori S, Bonanno N, Rico L, Contreras PN, Pagano EM, Blas L. Stent Syndrome: Does the Diameter Matter? Results of a Randomized Trial. Journal of Endourology. 2024 Feb; 38(2): 193-7. doi: 10.1089/end.2023.0378.

Allam CL, Aden JK, Reed AM. The role of Routine Ureteral Stenting following uncomplicated ureteroscopic treatment for Upper Ureteral and Renal stones: a Randomized Control Trial. Journal of Endourology. 2023 Mar; 37(3): 257-63. doi: 10.1089/end.2022.0386.

Girtner F, Fritsche HM, Zeman F, Huber T, Haider M, Pickl C et al. Randomized crossover-controlled evaluation of simultaneous bilateral transcutaneous electrostimulation of the posterior tibial nerve during urodynamic studies in patients with lower urinary tract symptoms. International Neurourology Journal. 2021 Jan; 25(4): 337. doi: 10.5213/inj.2040408.204.