title: Indwelling ureteral stents: evaluation of symptoms, quality of life and utility.
abstract: OBJECTIVE
  We report the prevalence of symptoms associated with ureteral stents, their impact on health related quality of life and utility analysis based on the validation studies of the new ureteral stent symptom questionnaire (USSQ).
  
  
  METHODS
  A total of 85 consecutive adult patients with unilateral indwelling ureteral stents who were asked to participate during the validation phases of the USSQ were considered for this analysis. They were asked to complete the USSQ and the EuroQol, a weighted utility instrument, 4 weeks after stent insertion and removal. In addition, 40 patients were asked to complete these questionnaires 1 week after stent insertion to assess the prevalence of symptoms and utility values at different times.
  
  
  RESULTS
  Of the 85 patients 62 (73%) with a mean age of 50 years completed the necessary questionnaires. Urinary symptoms and pain that affected work performance and general health were important stent related problems. Of the patients 78% reported bothersome urinary symptoms that included storage symptoms, incontinence and hematuria. More than 80% of patients experienced stent related pain affecting daily activities, 32% reported sexual dysfunction, and 58% reported reduced work capacity and negative economic impact. The mean EuroQol utility values, which indicate patient satisfaction with treatment, were significantly reduced following stent insertion.
  
  
  CONCLUSIONS
  Urinary symptoms and pain associated with indwelling ureteral stents interfere with daily activities and result in reduced quality of life in up to 80% of patients. Stents are associated with negative functional capacity and reduced utility values. The results have implications in terms of routine clinical practice, patient counseling and future stent research.
authors.affiliation: Bristol Urological Institute, Southmead Hospital, United Kingdom.
authors.forename: H B
authors.initials: HB
authors.lastname: Joshi
authors.forename: A
authors.initials: A
authors.lastname: Stainthorpe
authors.forename: R P
authors.initials: RP
authors.lastname: MacDonagh
authors.forename: F X
authors.initials: FX
authors.lastname: Keeley
authors.forename: A G
authors.initials: AG
authors.lastname: Timoney
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Barry
mesh_terms: D000203:Activities of Daily Living; D020878:Device Removal; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D012725:Sexual Behavior; D015607:Stents / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014513:Ureter; D014555:Urination Disorders / Q000209:etiology