Journal article
Risk Factors for Increased Stent-associated Symptoms Following Ureteroscopy for Urinary Stones: Results From STENTS
The Journal of urology, Vol.209(5), pp.971-980
05/2023
DOI: 10.1097/JU.0000000000003183
PMID: 36648152
Abstract
Purpose: The STudy to Enhance uNderstanding of sTent-associated Symptoms sought to identify risk factors for pain and urinary symptoms, as well as how these symptoms interfere with daily activities after ureteroscopy for stone treatment.
Materials and Methods: This prospective observational cohort study enrolled patients aged >= 12 years undergoing ureteroscopy with ureteral stent for stone treatment at 4 clinical centers. Participants reported symptoms at baseline; on postoperative days 1, 3, 5; at stent removal; and day 30 post-stent removal. Outcomes of pain intensity, pain interference, urinary symptoms, and bother were captured with multiple instruments. Multivariable analyses using mixed-effects linear regression models were identified characteristics associated with increased stent-associated symptoms.
Results: A total of 424 participants were enrolled. Mean age was 49 years (SD 17); 47% were female. Participants experienced a marked increase in stent-associated symptoms on postoperative day 1. While pain intensity decreased similar to 50% from postoperative day 1 to postoperative day 5, interference due to pain remained persistently elevated. In multivariable analysis, older age was associated with lower pain intensity (P = .004). Having chronic pain conditions (P < .001), prior severe stent pain (P = .021), and depressive symptoms at baseline (P < .001) were each associated with higher pain intensity. Neither sex, stone location, ureteral access sheath use, nor stent characteristics were drivers of stent-associated symptoms.
Conclusions: In this multicenter cohort, interference persisted even as pain intensity decreased. Patient factors (eg, age, depression) rather than surgical factors were associated with symptom intensity. These findings provide a foundation for patient-centered care and highlight potential targets for efforts to mitigate the burden of stent-associated symptoms.
Details
- Title: Subtitle
- Risk Factors for Increased Stent-associated Symptoms Following Ureteroscopy for Urinary Stones: Results From STENTS
- Creators
- Jonathan D. Harper - University of WashingtonAlana C. Desai - Washington University in St. LouisNaim M. Maalouf - The University of Texas Southwestern Medical CenterHongqiu Yang - Duke UniversityJodi A. Antonelli - Duke UniversityGregory E. Tasian - Children's Hospital of PhiladelphiaH. Henry Lai - Washington University in St. LouisPeter P. Reese - University of PennsylvaniaMichele Curatolo - University of WashingtonZiya Kirkali - NIDDK, Bethesda, MD USAHussein R. Al-Khalidi - Duke UniversityHunter Wessells - University of WashingtonCharles D. Scales - Duke UniversityUrinary Stone Dis Res Network
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.209(5), pp.971-980
- DOI
- 10.1097/JU.0000000000003183
- PMID
- 36648152
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 10
- Language
- English
- Date published
- 05/2023
- Academic Unit
- Urology
- Record Identifier
- 9985244561402771
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