Do ureteric stent extraction strings affect stent‐related quality of life or complications after ureteroscopy for urolithiasis: a prospective randomised control trial

• Published in: BJU international Vol. 113; no. 4; pp. 605 - 609
• Main Authors: Barnes, Kerri T., Bing, Megan T., Tracy, Chad R.
• Format: Journal Article
• Language: English
• Published: Oxford Wiley-Blackwell 01.04.2014; Wiley Subscription Services, Inc
• Subjects: Biological and medical sciences; Device Removal - adverse effects; Device Removal - instrumentation; Female; Foreign-Body Migration - etiology; Humans; Kidney Calculi - surgery; Male; Medical sciences; Middle Aged; nephrolithiasis; Nephrology. Urinary tract diseases; Pain Measurement; Pain, Postoperative - etiology; Prospective Studies; Prosthesis Design; Quality of Life; Stents; Stents - adverse effects; Surveys and Questionnaires; Ureteral Calculi - surgery; ureteric stent; Ureteric Stent Symptom Questionnaire (USSQ); ureteroscopy; Ureteroscopy - adverse effects; Urinary lithiasis; Urinary Tract Infections - etiology; Kidney disease; Endoprosthesis; Nephrology; Urinary system disease; Questionnaire; Ureteric Stent Symptom Questionnaire (USSQ); Check; Instrumentation therapy; Ureteroscopy; Stent; Urology; Urinary stone; Quality of life; Prospective; Symptomatology; Renal lithiasis; ureteric stent; nephrolithiasis; Complication; Clinical trial; Extraction; Endoscopy; Ureter
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/bju.12541

Objective To determine whether ureteric stent extraction strings affect stent‐related quality of life (QoL) or increase complications after ureteroscopy (URS) for stone disease. Patients and Methods In all, 68 patients undergoing URS (October 2011 to May 2013) for stone disease were randomised to receive a ureteric stent with or without an extraction string. Patients completed the Ureteric Stent Symptom Questionnaire (USSQ) on postoperative days 1 and 6, and 6 weeks after stent removal. Pain was assessed at stent removal. Adverse events, including early stent removal, stent migration, retained stent, urinary tract infection (UTI), emergency room (ER) visits and postoperative phone calls were monitored. Results There was no difference in stent‐related QoL as measured by the USSQ between those with and without a stent extraction string, pain at stent removal between those who pulled their stent independently vs those who underwent cystoscopy for stent removal, or in the rate of UTIs, ER visits or phone calls between groups. Five patients (four female, one male) removed their stent early by inadvertently pulling the string; none required replacement. Patients without a string had a significantly longer period with the postoperative ureteric stent (10.6 vs 6.3 days, P < 0.001). One patient without a stent string retained her ureteric stent for 6 months, which was removed by cystoscopy without incident. Conclusion Ureteric stent extraction strings may offer several advantages without increasing stent‐related urinary symptoms, complications, or postoperative morbidity.