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The intraureteral placement of the stent’s distal end decreases stent-related urinary symptoms: a prospective randomized clinical trial

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Abstract

Purpose

We compared intraureteral stent placement (CIU-SP) with conventional stent placement (C-SP) regarding the stent-related symptoms.

Methods

We randomized patients who underwent ureteroscopic lithotripsy into two groups. In CIU-SP group, a 16-cm or 18-cm stent was placed with its distal end above the ureterovesical junction. In C-SP group, a 22-cm or 24-cm stent was placed in a conventional method. Stent-related symptoms were assessed with the Ureteral Stent Symptom Questionnaire (USSQ) before the stent was removed, around 7 days after the operation. The primary outcome was the urinary symptoms; the secondary outcomes included postoperative pain and quality of life.

Results

We randomized 103 patients, of which 91 (45 in CIU-SP and 46 in C-SP) entered the final analysis. Regarding the primary endpoint, the CIU group had less urinary symptoms; the mean USSQ urinary symptom score was significantly lower in the CIU-SP versus C-SP group (25.5 ± 6.3 vs 31.7 ± 5.9, P < 0.001). The CIU-SP group also had more favorable profiles in the following outcomes: lower USSQ body pain score (15.5 ± 5.3 vs 20.1 ± 5.2, P < 0.001), lower overall pain score (3.2 ± 2.2 vs 5.7 ± 2.3, P < 0.001), less number of pain site (1.0 ± 0.9 vs 1.7 ± 0.9, P = 0.001, lower USSQ general health score (10.4 ± 3.7 versus 13.9 ± 3.4, P < 0.001), and lower USSQ work performance score (5.2 ± 3.3 versus 6.7 ± 2.8, P = 0.033). In either group, there was no complication of Clavien–Dindo Class 2 or greater.

Conclusion

The complete intraureteral placement significantly decreases stent-related urinary symptoms and pain. It is also associated with better postoperative general health condition and is less likely to limit physical activity and work ability.

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Funding

This study was supported by a grant (2021SKHBDR001) from Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

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Authors and Affiliations

  1. Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Kai-Yi Tzou, Kuan-Chou Chen, Chia-Chang Wu & Su-Wei Hu

  2. Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Kai-Yi Tzou, Kuan-Chou Chen & Chia-Chang Wu

  3. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Kuan-Chou Chen

  4. Division of Urology, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

    Chen-Hsun Ho

  5. School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan

    Chen-Hsun Ho

Authors
  1. Kai-Yi Tzou
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  2. Kuan-Chou Chen
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  3. Chia-Chang Wu
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  4. Su-Wei Hu
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  5. Chen-Hsun Ho
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Contributions

KYT: data collection, data analysis. KCC: data collection. CCW: data collection. SWH: data collection. CHH: data collection, data analysis, manuscript writing, supervising the study program.

Corresponding author

Correspondence to Chen-Hsun Ho.

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All the authors declare that they have no conflict of interest.

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Tzou, KY., Chen, KC., Wu, CC. et al. The intraureteral placement of the stent’s distal end decreases stent-related urinary symptoms: a prospective randomized clinical trial. World J Urol 40, 2129–2134 (2022). https://doi.org/10.1007/s00345-022-04057-5

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  • DOI: https://doi.org/10.1007/s00345-022-04057-5

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