Clinical Effectiveness of Single Pigtail Suture Stent on Patient Comfort: A Double-Blind Prospective Randomized Trial

Bostanci, Yakup; Mercimek, Mehmet Necmettin; Gülşen, Murat Taner; Özden, Ender; Yakupoğlu, Yarkın Kamil; Sarıkaya, Şaban

doi:10.1089/lap.2020.0127

Cited by 19 publications

(23 citation statements)

References 25 publications

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“…Their observational study showed a decrease in USSQ scores among 24 patients strongly complaining of SRS who had a DJ stent replaced with a PSS. Two recent RCTs of self-manufactured PSS showed a reduction in SRS [16] , [17] . However, these studies are of limited use because of poor reproducibility and potential risks related to self-modification of a medical device, severely limiting their application to clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial

Bosio

Alessandria

Agosti

et al. 2021

European Urology Open Science

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Background Double J (DJ) ureteral stents are commonly inserted after ureteroscopy (URS) procedures for stone treatment. However, stent-related symptoms are still a major issue. Objective To determine whether a commercially available pigtail suture stent (PSS) can reduce stent-related symptoms compared to a conventional DJ stent after uncomplicated URS. Design, setting, and participants We designed a randomized, single-blind, parallel-group trial from January to November 2020. The inclusion criteria were stone-free URS without intraprocedural complications. Patients with distal ureteral stones were excluded. Intervention Insertion of a PSS or DJ stent after URS. Outcome measurements and statistical analysis The primary endpoint was the Urinary Symptom Index score on the Ureteral Stent Symptoms Questionnaire (USSQ) 2 wk after URS. Secondary endpoints were USSQ domain scores and responses to individual USSQ questions at 2 d and 2 wk after surgery. Results and limitations A total of 78 patients were randomized and treated according to protocol. The Urinary Symptom Index score ( p = 0.004), overall Visual Analogue Scale (VAS) score ( p = 0.022), and the percentage of patients complaining of pain (63.9% vs 86.1%, p = 0.029) were significantly in favor of PSS at both 2 d and 2 wk after URS. At 2 d, the VAS score among patients with pain ( p = 0.025) and the General Health Index score ( p = 0.036) were significantly better in the PSS group. No severe complications occurred in either group. Study limitations are the exclusion of patients with distal ureteral stones and the limited sample size. Conclusions PSS significantly reduced stent-related symptoms after URS, in particular urinary symptoms and pain, compared to conventional DJ stents, and showed a good safety profile. Patient summary Stents are hollow tubes placed in the passage between the kidney and the bladder (ureter). The standard stent has two coiled ends (double J stent) to keep it in place in both the kidney and the bladder. We tested a commercial stent with two strings at the bladder end (pigtail suture stent) after procedures to remove stones from the upper urinary tract and found that it caused less stent-related symptoms compared to a double J stent. This trial is registered at Clinicaltrials.gov as NCT03344120.

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Section: Discussionmentioning

confidence: 99%

Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial

Bosio

Alessandria

Agosti

et al. 2021

European Urology Open Science

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“…The results of other studies showing a reduction in SRS when using LT stents should be considered with caution due to limitations of trial design and lack of validated questionnaires [6,7], retrospective analysis [7], and poor reproducibility due to self-made stents [12].…”

Section: Discussionmentioning

confidence: 99%

Loop‐tail stents fail in reducing stent‐related symptoms: results of a prospective randomised controlled trial

Bosio¹,

Alessandria²,

Agosti³

et al. 2021

BJU International

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To compare stent-related symptoms (SRS) of loop-tail (LT) and conventional double J (DJ) stents after uncomplicated flexible ureterorenoscopy (fURS), in a prospective randomised controlled single-blind parallel-group study. Patients and MethodsPatients undergoing fURS were randomised into two groups: the LT Group received LT stents (Polaris TM Loop) and the DJ Group received conventional DJ stents (Vortek â ). The stent was removed after 4 weeks. The Ureteric Stent Symptom Questionnaire (USSQ) was administered at 2 days, 4 and 8 weeks (baseline evaluation) after stent insertion. The primary endpoint was to compare the Urinary Symptom Index Score of the LT vs DJ groups at 4 weeks after stent insertion. The secondary endpoints were to compare the USSQ domains' subscores at 2 days and 4 weeks after stent insertion, USSQ single answers at 4 weeks, and the 4-week USSQ domains' subscores adjusted for baseline. ResultsA total of 68 patients were randomised (34 LT and 34 DJ). The answers given at 4 weeks were not significantly different between the two groups for the Urinary Symptom Index Score (P = 0.982), Pain Index Score (P = 0.169), visual analogue scale (P = 0.276), and all the other domains of the USSQ. At 4 weeks, the single-answer analysis did not find any differences between the groups; the urinary symptoms were all comparable, as was the requirement for pain painkillers (P = 0.684) and pain during sex (P = 0.496). There were also no significant differences for every single domain score for the responses given at 2 days. The same applied to USSQ subscores at 4 weeks adjusted for the 8-week baseline results, which were also comparable. ConclusionsThe study found no differences in terms of SRS between the LT and DJ groups, either at 2 days or 4 weeks after stent insertion, with or without baseline correction.

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“…Another randomized controlled study found significantly lower pain scores and analgesic requirements in a PSS group compared to a conventional polyurethane double pigtail stent after uncomplicated URS for symptomatic ureteral stones ( 8 ). This new type of ureteral stent may be effective following flexible ureteroscopy while also reducing stent-related symptoms compared to other ureteral stents ( 9 ).…”

Section: Pigtail Suture Stentmentioning

confidence: 99%

Developments in Ureteral Stent Technology

2021

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Ureteral stents have been utilized for decades in maintaining ureteral patency, most commonly after ureteroscopy in the treatment of urolithiasis. Since their initial development, ureteral stents have had many technological advances that have allowed for better patient outcomes with improvements in comfort, durability, patency, encrustation resistance, biocompatibility, ease of insertion, migration, and biofilm development. Several new ureteral stents enter the market every year, each with their own touted benefits. It is essential to understand the different advantages for each ureteral stent to provide the best available care to patients when possible. The purpose of this review is to give a brief history of ureteral stent development and summarize the recent developments in ureteral stent designs. We aim to review the data supporting the clinical advantages of the latest ureteral stents available for use by urologists.

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Clinical Effectiveness of Single Pigtail Suture Stent on Patient Comfort: A Double-Blind Prospective Randomized Trial

Cited by 19 publications

References 25 publications

Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial

Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial

Loop‐tail stents fail in reducing stent‐related symptoms: results of a prospective randomised controlled trial

Developments in Ureteral Stent Technology

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