Korean J Urol.  2015 May;56(5):370-378. 10.4111/kju.2015.56.5.370.

Is intravesical stent position a predictor of associated morbidity?

• Abt D
• Mordasini
• Warzinek E
• Schmid HP
• Haile SR
• Engeler DS
• Mullhaupt

• KMID: 2155317
• DOI: http://doi.org/10.4111/kju.2015.56.5.370

Abstract

PURPOSE
Temporary drainage of the upper urinary tract by use of internal ureteral stents is a common procedure that is often associated with a variety of symptoms. The role of intravesical stent position in associated morbidity is controversial.
MATERIALS AND METHODS
The German version of the ureteral stent symptom questionnaire (USSQ) was completed by 73 patients with an indwelling ureteral stent the day before stent removal. Intravesical stent position was classified into 3 categories by x-ray before stent removal. The influence of intravesical stent position on USSQ score was analyzed, including subscores and single items.
RESULTS
Intravesical stent position showed no significant influence on associated morbidity. The median USSQ total score in all patients was 77.5 (range, 30-147). Patients with ipsilateral stents (69.0; range, 30-122) tended to have lower total scores than did those with tangential (86.5; range, 30-122) or contralateral (77.0; range, 31-147) stents, but the differences were not statistically significant (p=0.35). The USSQ subscores for urinary symptoms (p=0.80), body pain (p=0.80), general health (p=0.16), work performance (p=0.07), additional problems (p=0.81), and all of the USSQ single items of interest in the context of stent length also did not differ significantly between the three groups.
CONCLUSIONS
Intravesical stent position did not significantly influence associated morbidity in our study. An appropriate stent length should be chosen to avoid dislocation. However, complex calculations of optimum stent length, time-consuming manipulations, and costly stock holding of various stent sizes to obtain the perfect stent position do not seem worthwhile.

Keyword

Morbidity; Pain; Questionnaires; Stents; Ureter

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Humans
Lower Urinary Tract Symptoms/*etiology
Male
Middle Aged
*Morbidity
Pain
Prognosis
Quality of Life
Stents/*adverse effects
Surveys and Questionnaires
Ureter/*radiography
Young Adult

Figure

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  Fig. 1 Classification of intravesical stent length based on a perpendicular line through the middle of the gap of the symphysis pubis: loop completely ipsilateral (A), crossing midline (B), and completely contralateral (C).

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  Fig. 2 Study patient treated by shock wave lithotripsy (SWL) secondary to stenting with pushback. X-rays performed before and after treatment show high variability of distal stent location. (A) Intraoperative x-ray. (B) One day after stent insertion. (C) Three weeks after insertion (before SWL). (D) Three weeks after SWL (before stent removal).

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