New Ureteral Stent Design Does Not Improve Patient Quality of Life: A Randomized, Controlled Trial

Davenport, Kim; Kumar, Vivekanandan; Collins, Justin; Melotti, Roberto; Timoney, Anthony G.; Keeley, Francis X.

doi:10.1016/j.juro.2010.08.089

Cited by 44 publications

(31 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As has been found in multiple other survey studies, response to the USSQ survey was lower than anticipated, so that reaching our target enrolment was not possible within the constraints of the present study and may have underpowered the study to detect slight differences in patient outcomes. However, survey compliance was similar between cohorts and only slightly lower than similar studies using the USSQ as a survey tool [9,[16][17][18]. Furthermore, the accrual rate was also lower than anticipated, with only 25% of patients approached agreeing to participate.…”

Section: Discussionmentioning

confidence: 65%

Do ureteric stent extraction strings affect stent‐related quality of life or complications after ureteroscopy for urolithiasis: a prospective randomised control trial

2014

View full text Add to dashboard Cite

Objective To determine whether ureteric stent extraction strings affect stent‐related quality of life (QoL) or increase complications after ureteroscopy (URS) for stone disease. Patients and Methods In all, 68 patients undergoing URS (October 2011 to May 2013) for stone disease were randomised to receive a ureteric stent with or without an extraction string. Patients completed the Ureteric Stent Symptom Questionnaire (USSQ) on postoperative days 1 and 6, and 6 weeks after stent removal. Pain was assessed at stent removal. Adverse events, including early stent removal, stent migration, retained stent, urinary tract infection (UTI), emergency room (ER) visits and postoperative phone calls were monitored. Results There was no difference in stent‐related QoL as measured by the USSQ between those with and without a stent extraction string, pain at stent removal between those who pulled their stent independently vs those who underwent cystoscopy for stent removal, or in the rate of UTIs, ER visits or phone calls between groups. Five patients (four female, one male) removed their stent early by inadvertently pulling the string; none required replacement. Patients without a string had a significantly longer period with the postoperative ureteric stent (10.6 vs 6.3 days, P < 0.001). One patient without a stent string retained her ureteric stent for 6 months, which was removed by cystoscopy without incident. Conclusion Ureteric stent extraction strings may offer several advantages without increasing stent‐related urinary symptoms, complications, or postoperative morbidity.

show abstract

Section: Discussionmentioning

confidence: 65%

Do ureteric stent extraction strings affect stent‐related quality of life or complications after ureteroscopy for urolithiasis: a prospective randomised control trial

2014

View full text Add to dashboard Cite

show abstract

“…Some investigators have demonstrated (16,17) improving impact of alpha-blockers including alfuzosin and terazosin on stent-related discomforts, whereas Kuyumcuoglu et al (19) concluded that stent discomforts remained unchanged even after administering doxazosin, therefore, they argued that a new strategy and stent design are required to attenuate stent-related complications; however, a recently published study has demonstrated that the new stents did not improve stent-related symptoms (20). Considering the current study and the two meta-analyses that have been recently published (21,22), it seems that alpha-blockers can effectively relieve stent-related symptoms.…”

Section: Discussionmentioning

confidence: 99%

Effects of Terazosin and Tolterodine on Ureteral Stent Related Symptoms: A Double-Blind Placebo-Controlled Randomized Clinical Trial

et al. 2013

View full text Add to dashboard Cite

Objective: To evaluate the effects of terazosin and tolterodine on ureteral stent discomfort. Materials and Methods: Of 163 patients assessed for eligibility, 104 patients were randomly assigned to receive placebo, 2 mg of terazosin twice daily, 2 mg of tolterodine daily, or both terazosin plus tolterodine during the stenting period. Prior to stenting and at stent removal, the International Prostate Symptom Score (IPSS), the IPSS quality of life (QoL) subscore and the Visual Analog Scale for Pain were determined. The patients also reported their analgesic use during the stenting period. Results: Ninety-four patients completed the study. We noted significant decreases in the total IPSS scores (p = 0.002), irritative subscore (p = 0.039), QoL (p = 0.001), flank pain (p = 0.013), voiding pain (p = 0.01) and amount of analgesics used (p = 0.02) in the groups. However, neither the obstructive subscore nor the suprapubic pain improved significantly (p = 0.251 and p = 0.522, respectively). The patients receiving terazosin plus tolterodine experienced significant reductions in the total IPSS, irritative symptoms, QoL, flank pain, voiding pain and decreased analgesics use compared with those patients receiving placebo. However, compared with placebo, terazosin monotherapy did not affect pain levels, and tolterodine monotherapy did not improve QoL, flank pain or analgesics use. Conclusions: Terazosin plus tolterodine improves ureteral stent-related complications, including irritative symptoms, the amount of analgesics used, QoL, flank pain and voiding pain but does not decrease obstructive symptoms or suprapubic pain. This trial was registered at www.clinicaltrials.gov as NCT01530243.

show abstract

“…The main limitation of the present study is of the low response rate, with only 74% of patients returning at least the week 1 questionnaire. However, the non‐return rate was similar in each group and multiple previous studies have also reported low response rates using similar questionnaires . The present study was therefore only adequately powered (>80%) at week 1 to detect the differences set out initially for the ‘urinary symptoms’ and ‘general health’ domains.…”

Section: Discussionmentioning

confidence: 99%

Multi‐length or 24 cm ureteric stent? A multicentre randomised comparison of stent‐related symptoms using a validated questionnaire

et al. 2012

Self Cite

View full text Add to dashboard Cite

What's known on the subject? and What does the study add?• One of the suggested factors for stent-related symptoms is that excess distal intravesical stent mass may cause bladder irritation. There is a lack of studies investigating this in a randomised controlled fashion using a validated questionnaire.• This study compared two of the most commonly used length of stents (a 30 cm multi-length vs a 24 cm long stent) and showed no significance difference in stent-related symptoms in patients with either of these stents. Objective• To investigate whether excessive redundant intravesical stent component contributes to the severity of stent-related symptoms in patients with a ureteric stent. We compared stent-related symptoms in patients who had either a standard 24 cm or multi-length ureteric stent. Patients and Methods• In all, 162 patients with upper urinary tract calculi requiring ureteric stent insertion were randomised to receive either a 6 F ¥ 24 cm Contour TM or multi-length 6 F ¥ 22-30 cm Contour VL TM stent.• Patients were requested to complete the validated Bristol Ureteric Stent Symptom Questionnaire (USSQ) at 1 and 4 weeks after stent insertion and 4 weeks after removal.• The mean scores for each domain of the USSQ for both groups were compared using the Student's t-test.• Any adverse events, e.g. stent migration, early removal of stent due to stent-related symptoms and failure of stent insertion, were also recorded. Results• In all, 153 patients who had successful stent insertion were requested to complete the USSQ and 74% of patients returned at least the week 1 questionnaire.• At 1 and 4 weeks with the stent in situ, comparison of the mean scores showed no significant difference in urinary symptoms, pain, general health, work performance, sexual dysfunction and number of days patients stayed in bed or reduced their routine activities. • Three (2%) patients had their stent removed early due to stent-related symptoms and five (3%) had failed stent insertion. Conclusions• This study did not find any difference in symptoms between the 24 cm or multi-length Contour stents. However, the study was not powered to detect small differences particularly for the pain symptom domain.• Stents should only be used sparingly and the stent dwell-time should be minimised.

show abstract

New Ureteral Stent Design Does Not Improve Patient Quality of Life: A Randomized, Controlled Trial

Abstract: The Polaris stent, designed with the specific aim of improving urinary symptoms and pain associated with ureteral stents, continues to have a significant detrimental effect on patient quality of life.

Cited by 44 publications

References 10 publications

Do ureteric stent extraction strings affect stent‐related quality of life or complications after ureteroscopy for urolithiasis: a prospective randomised control trial

Do ureteric stent extraction strings affect stent‐related quality of life or complications after ureteroscopy for urolithiasis: a prospective randomised control trial

Effects of Terazosin and Tolterodine on Ureteral Stent Related Symptoms: A Double-Blind Placebo-Controlled Randomized Clinical Trial

Multi‐length or 24 cm ureteric stent? A multicentre randomised comparison of stent‐related symptoms using a validated questionnaire

Contact Info

Product

Resources

About