Self-retaining ureteral stents: analysis of factors responsible for patients' discomfort.
OBJECTIVE
To determine factors affecting patients' discomfort during the period self-retaining ureteral stents are in place.


METHODS
Between April 2001 and May 2003, 58 male and 42 female patients underwent temporary double-pigtail stenting. The indications were endopyelotomy in 39 patients, ureteroscopy in 32, laparoscopic pyeloplasty in 18, and endoureterotomy in 11. The stents were silicone in 56 patients and Percuflex in 44. The median stenting period was 8 weeks (range 4-16 weeks). Patient discomfort was evaluated by a questionnaire conducted by the physician before stent removal. Tested variables were patients' sex, side of the stent, urine culture, stent material, stent length and diameter, and stenting duration. The site of the upper coil (renal pelvis or calix), the site of the lower coil (in the same side or crossing the midline), and the shape of the lower coil (complete circle or not) were also tested. Univariate and multivariate analysis were carried out to determine significant independent variables, with P < 0.05 being significant.


RESULTS
Of the total, 59 patients experienced discomfort consisting of dysuria, urgency, urge incontinence, loin pain, suprapubic pain, frequency, nocturia, or gross hematuria or some combination. Significant factors associated with discomfort were a positive urine culture, crossing of the lower end of the stent to the opposite side, caliceal position of the upper coil, and longer stenting duration.


CONCLUSIONS
Proper positioning of the coils of the stent, eradication of infection, and shorter stenting duration are advised to decrease patient discomfort during the period of ureteral stenting.
El-Nahas
Ahmed R
AR
Mansoura Urology & Nephrology Center, Mansoura, Egypt. ar_el_nahas@yahoo.com
El-Assmy
Ahmed M
AM
Shoma
Ahmed M
AM
Eraky
Ibrahim
I
El-Kenawy
Mahmoud R
MR
El-Kappany
Hamdy A
HA
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D014555:Urination Disorders / Q000209:etiology*; D014567:Urography; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation