title: Patient experiences and preferences with ureteral stent removal.
abstract: OBJECTIVE
  Ureteral stent removal is a source of patient morbidity. We surveyed 599 patients to evaluate their experiences and identify the preferred method of stent removal.
  
  
  METHODS
  Visitors to a kidney stone website were invited to participate. Respondents were asked how their ureteral stent was removed? Pain during and after the procedure, patient experiences, and preferences regarding stent removal were queried. Chi-square and ANOVA tests were used to identify significant differences among removal methods.
  
  
  RESULTS
  Five hundred seventy-one respondents were included in the study. The majority of stents (44%) were removed by office cystoscopy while 39% had their stents removed by string. Mean pain during stent removal was 4.8 out of 10 with 57% reporting moderate-to-severe pain levels of 4 or more. Removal by office cystoscopy resulted in the highest experienced pain (5.3). Thirty-two percent reported delayed severe pain after stent removal, including 9% who returned for emergency care. Removal by string resulted in more emergency room visits when compared to cystoscopy. Willingness to undergo the same removal technique was lowest for those who underwent office cystoscopy and highest for operating room cystoscopy. Being informed of why a stent was placed and the removal process was of high priority for respondents.
  
  
  CONCLUSIONS
  The majority of patients report moderate-to-severe pain with stent removal and a third report delayed significant pain after stent removal. Variations exist in the patient experience with stent removal based on the method used. More research is needed to identify effective ways to prevent or manage stent-removal-related adverse events.
authors.affiliation: 1 USC Institute of Urology, Keck School of Medicine of USC , Los Angeles, California.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Loh-Doyle
authors.forename: Roger K
authors.initials: RK
authors.lastname: Low
authors.forename: Manoj
authors.initials: M
authors.lastname: Monga
authors.forename: Mike M
authors.initials: MM
authors.lastname: Nguyen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003558:Cystoscopy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D020878:Device Removal / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D057240:Patient Preference; D015607:Stents; D011795:Surveys and Questionnaires; D014513:Ureter; D055815:Young Adult