Purpose Double-pigtail stent intolerance reduces patient’s quality of life. By decreasing the amount of material within the bladder, it should be possible to attenuate stent’s symptoms. We evaluated the tolerance of a new stent with a dedicated questionnaire.MethodsThe major innovation of the pigtail suture stent (PSS) is in the replacement of the lower part of the double-pigtail stent with a 0.3F suture. A total of 79 consecutive patients agreed to be fitted with a PSS. The double-pigtail stents of 24 patients complaining strongly of symptoms were replaced with PSS (group 1), and 55 other patients were fitted directly with the PSS after an ureteral endoscopic intervention (group 2). The questionnaire was prospectively administered to patients at baseline and Day 15 post-placement.ResultsAll questionnaires were returned. In group 1, the replacement of the double-pigtail stent with a PSS significantly decreased urinary symptom scores (35.2 ± 7.5 vs. 23.6 ± 5.4; p = 2 × 10−6) and pain scores (11.0 ± 3.9 vs. 4.9 ± 3.1; p = 1 × 10−7). In group 1, the baseline scores were not significantly different from those of control group with double-pigtail stent. In group 2, the urinary scores with PSS were significantly different from those of baseline without stent. The scores of the two groups fitted with a PSS were not significantly different at Day 15 post-placement. Unexpectedly, following PSS implantation, we observe a clear dilation of the ureter without inflammation around the suture.ConclusionsThe PSS significantly decreases stent’s symptoms and constitutes a medical advance in the domain of ureteral stent tolerance.Electronic supplementary materialThe online version of this article (doi:10.1007/s00345-014-1394-2) contains supplementary material, which is available to authorized users.

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OBJECTIVES To determine whether renal hybrid tumours (HT) appear as a specific clinical and radiological entity, as HT are characterized by the association of both oncocytes and chromophobe cells within the same tumour, and have been described in patients with oncocytosis and Birt‐Hogg‐Dube syndrome. PATIENTS AND METHODS We reviewed the medical charts of 67 patients who had a partial or radical nephrectomy in our institution for renal oncocytoma (RO, 24), chromophobe renal cell carcinoma (CRCC, 36) and HT (seven), from January 2006 to October 2007. We report the clinical, radiological and pathological characteristics of the seven cases of HT. RESULTS The mean (range) age of the patients was 56 (41–68) year. None of the seven patients had any suspicion of RO, based on computed tomography (CT). Two patients had a history of kidney cancer. Five patients had partial and two a radical nephrectomy. The mean (range) maximum tumour diameter was 5.5 (1.8–9) cm. Two tumours were pT1a, two were pT1b and three were pT2. Pathological analysis showed RO‐like and CRCC‐like cells intermixed (six patients) or distinct (one). After a median (range) follow‐up of 20 (8–25) months, none of the patients had any evidence of disease recurrence. CONCLUSIONS In a large series of patients with sporadic RO and CRCC, 10% of the tumours had hybrid morphological features, as described in oncocytosis and Birt‐Hogg‐Dube syndrome. We were unable to identify any specific clinical characteristic. Most importantly, none of these HT showed any of the radiological characteristics of RO.

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OBJECTIVETo evaluate the stent-related symptoms using a new customized ureteral stent with a nonrefluxing silicone end-piece. METHODSBy decreasing the amount of material within the bladder, it should be possible to attenuate the stent-related symptoms. To minimize the amount of material, 17 consecutive patients already fitted with a double-pigtail stent for malignant ureteral obstruction agreed to be fitted with a customized stent where the bladder loop was replaced by a nonrefluxing silicone end-piece. The ureteral stent symptom questionnaire was prospectively administered to patients at baseline with doublepigtail stent and Day 15 after customized stent placement. RESULTSNo difficulty in the placement of the customized stent was encountered. No stent failure, no dislodgment and no calcification were observed 6 months after stenting. The scores for the main domain "Urinary symptoms" (34.4 § 3.6 vs 23.0 § 7.0; P = .0004) and the question "Global quality of life" (4.4 § 2.0 vs 2.4 § 2.1; P = .01) were significantly decreased by the replacement of the double-pigtail stent by the customized stent. CONCLUSIONThe customized ureteral stent may constitute an improvement in the field of stent-related symptoms and seems fit for use in its current shape. Studies exploring and exploiting new concepts are greatly required to reduce stent-related symptoms in all patients including those with cancer. UROLOGY 137: 45−49, 2020.