title: Determining the appropriate length of a double-pigtail ureteral stent by both stent configurations and related symptoms.
abstract: OBJECTIVE
  To evaluate whether stent length affects the symptoms after stent insertion and to determine the appropriate stent length according to the stent configurations and the related symptoms simultaneously.
  
  
  METHODS
  A total of 87 patients who underwent ureteroscopic lithotripsy (URSL) and double-pigtail ureteral stent (22, 24, or 26 cm) insertion were enrolled. The stent configurations on the images were reviewed to determine whether the length was appropriate. All patients completed a questionnaire to assess the symptoms related to stent insertion. The incidence and severity of the symptoms were compared among the patients with different stent lengths.
  
  
  RESULTS
  The demographic data were similar among the three groups with different stent lengths (22, 24, or 26 cm). The stent length was associated with the position of the distal loop (P = 0.02), while it was not associated with the position of the proximal loop (P = 0.50). The use of a longer stent was significantly associated with a higher incidence of urinary frequency (P = 0.04) and urgency (P = 0.02). Also, the use of a longer stent was also significantly associated with higher symptom scores of urinary frequency (P < 0.01) and urgency (P < 0.01).
  
  
  CONCLUSIONS
  The stent length is associated with the position of the distal loop and the related urinary symptoms. A longer stent causes an overlong intravesical segment and more irritative symptoms. On the other hand, the stent length is not associated with either the position of the proximal loop or flank pain. Based on the analysis of both stent configurations on images and related symptoms, a 22-cm stent is more appropriate for those whose height ranges from 149.5 cm to 178.5 cm with a median of 161.9 cm.
authors.affiliation: Department of Urology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
authors.forename: Chen-Hsun
authors.initials: CH
authors.lastname: Ho
authors.forename: Shyh-Chyan
authors.initials: SC
authors.lastname: Chen
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
authors.forename: Yuan-Ju
authors.initials: YJ
authors.lastname: Lee
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.forename: Hong-Jeng
authors.initials: HJ
authors.lastname: Yu
authors.forename: Kuo-How
authors.initials: KH
authors.lastname: Huang
mesh_terms: D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014513:Ureter / Q000473:pathology*