Effects of Three Different Ureteral Stents on Stent-Related Symptoms in Patients Undergoing Ureteroscopic Lithotripsy: Assessment Using the Ureteral Stent Symptoms Questionnaire

Abstract

Objective:

Ureteral stents are commonly used after ureteroscopic lithotripsy (URS) to prevent obstruction, but often cause stent-related symptoms (SRS), which can impact patients’ quality of life. The Ureteral Stent Symptoms Questionnaire (USSQ) is a validated tool for assessing these symptoms. This study aimed to compare the SRS of three ureteral stents: conventional Double-J (cDJ, Tria), soft DJ (sDJ, Tria Soft), and loop-tail (LT, Polaris Loop), using the Japanese version of the USSQ.

Methods:

In this multicenter, prospective cohort study, 96 patients undergoing URS for upper urinary tract stones were enrolled and evenly assigned to one of the three stent groups. The USSQ was administered at baseline, 2 and 14 days after stent placement, and 2 weeks after stent removal. The primary end point was the USSQ score on postoperative day 14. The secondary end points included USSQ scores on day 2, postremoval, and score changes over time. Statistical analysis was performed using paired and unpaired t-tests, with p < 0.05 considered significant.

Results:

On day 14, the LT group showed significantly better general health index scores than the cDJ group (p < 0.001), whereas the sDJ group showed a favorable trend (p = 0.054). The LT group had worse scores in the sexual matters domain (p = 0.011), although all groups scored low. There were no significant between-group differences in urinary symptoms, pain, or work performance. The LT and sDJ groups had significantly better general health index scores than the cDJ group on day 2 and after removal. Urinary symptoms and pain were highest early poststenting and improved significantly over time (p < 0.001).

Conclusion:

The Polaris Loop stent significantly reduced SRS compared with the Tria stent, whereas the Tria Soft stent showed a favorable trend toward improvement. Because SRS is a major patient concern, general health should be considered alongside urinary and pain symptoms when selecting an optimal stent.