Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial
Background: Double J (DJ) ureteral stents are commonly inserted after ureteroscopy (URS) procedures for stone treatment. However, stent-related symptoms are still a major issue. Objective: To determine whether a commercially available pigtail suture stent (PSS) can reduce stent-related symptoms comp...
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doaj-aea18180795c4a7b92c9ac993c07e71f2021-06-25T04:50:25ZengElsevierEuropean Urology Open Science2666-16832021-07-012919Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized TrialAndrea Bosio0Eugenio Alessandria1Simone Agosti2Federico Vitiello3Eugenia Vercelli4Alessandro Bisconti5Paolo Piana6Fabrizio Fop7Paolo Gontero8Department of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, Italy; Corresponding author. Department of Urology, Città della Salute e della Scienza, Molinette University Hospital, Corso Bramante 88, 10126 Turin, Italy. Tel. +39 01 16335709; Fax: +39 01 16335691.Department of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, ItalyDepartment of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, ItalyDepartment of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, ItalyDepartment of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, ItalyDepartment of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, ItalyDepartment of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, ItalyDepartment of Nephrology, Dialysis and Renal Transplantation, Città della Salute e della Scienza, Molinette University Hospital, Turin, ItalyDepartment of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, ItalyBackground: Double J (DJ) ureteral stents are commonly inserted after ureteroscopy (URS) procedures for stone treatment. However, stent-related symptoms are still a major issue. Objective: To determine whether a commercially available pigtail suture stent (PSS) can reduce stent-related symptoms compared to a conventional DJ stent after uncomplicated URS. Design, setting, and participants: We designed a randomized, single-blind, parallel-group trial from January to November 2020. The inclusion criteria were stone-free URS without intraprocedural complications. Patients with distal ureteral stones were excluded. Intervention: Insertion of a PSS or DJ stent after URS. Outcome measurements and statistical analysis: The primary endpoint was the Urinary Symptom Index score on the Ureteral Stent Symptoms Questionnaire (USSQ) 2 wk after URS. Secondary endpoints were USSQ domain scores and responses to individual USSQ questions at 2 d and 2 wk after surgery. Results and limitations: A total of 78 patients were randomized and treated according to protocol. The Urinary Symptom Index score (p = 0.004), overall Visual Analogue Scale (VAS) score (p = 0.022), and the percentage of patients complaining of pain (63.9% vs 86.1%, p = 0.029) were significantly in favor of PSS at both 2 d and 2 wk after URS. At 2 d, the VAS score among patients with pain (p = 0.025) and the General Health Index score (p = 0.036) were significantly better in the PSS group. No severe complications occurred in either group. Study limitations are the exclusion of patients with distal ureteral stones and the limited sample size. Conclusions: PSS significantly reduced stent-related symptoms after URS, in particular urinary symptoms and pain, compared to conventional DJ stents, and showed a good safety profile. Patient summary: Stents are hollow tubes placed in the passage between the kidney and the bladder (ureter). The standard stent has two coiled ends (double J stent) to keep it in place in both the kidney and the bladder. We tested a commercial stent with two strings at the bladder end (pigtail suture stent) after procedures to remove stones from the upper urinary tract and found that it caused less stent-related symptoms compared to a double J stent.This trial is registered at Clinicaltrials.gov as NCT03344120.http://www.sciencedirect.com/science/article/pii/S2666168321000781Double J stentLower urinary tract symptomsNephrolithiasisPainPigtail suture stentsStents |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Andrea Bosio Eugenio Alessandria Simone Agosti Federico Vitiello Eugenia Vercelli Alessandro Bisconti Paolo Piana Fabrizio Fop Paolo Gontero |
spellingShingle |
Andrea Bosio Eugenio Alessandria Simone Agosti Federico Vitiello Eugenia Vercelli Alessandro Bisconti Paolo Piana Fabrizio Fop Paolo Gontero Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial European Urology Open Science Double J stent Lower urinary tract symptoms Nephrolithiasis Pain Pigtail suture stents Stents |
author_facet |
Andrea Bosio Eugenio Alessandria Simone Agosti Federico Vitiello Eugenia Vercelli Alessandro Bisconti Paolo Piana Fabrizio Fop Paolo Gontero |
author_sort |
Andrea Bosio |
title |
Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial |
title_short |
Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial |
title_full |
Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial |
title_fullStr |
Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial |
title_full_unstemmed |
Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial |
title_sort |
pigtail suture stents significantly reduce stent-related symptoms compared to conventional double j stents: a prospective randomized trial |
publisher |
Elsevier |
series |
European Urology Open Science |
issn |
2666-1683 |
publishDate |
2021-07-01 |
description |
Background: Double J (DJ) ureteral stents are commonly inserted after ureteroscopy (URS) procedures for stone treatment. However, stent-related symptoms are still a major issue. Objective: To determine whether a commercially available pigtail suture stent (PSS) can reduce stent-related symptoms compared to a conventional DJ stent after uncomplicated URS. Design, setting, and participants: We designed a randomized, single-blind, parallel-group trial from January to November 2020. The inclusion criteria were stone-free URS without intraprocedural complications. Patients with distal ureteral stones were excluded. Intervention: Insertion of a PSS or DJ stent after URS. Outcome measurements and statistical analysis: The primary endpoint was the Urinary Symptom Index score on the Ureteral Stent Symptoms Questionnaire (USSQ) 2 wk after URS. Secondary endpoints were USSQ domain scores and responses to individual USSQ questions at 2 d and 2 wk after surgery. Results and limitations: A total of 78 patients were randomized and treated according to protocol. The Urinary Symptom Index score (p = 0.004), overall Visual Analogue Scale (VAS) score (p = 0.022), and the percentage of patients complaining of pain (63.9% vs 86.1%, p = 0.029) were significantly in favor of PSS at both 2 d and 2 wk after URS. At 2 d, the VAS score among patients with pain (p = 0.025) and the General Health Index score (p = 0.036) were significantly better in the PSS group. No severe complications occurred in either group. Study limitations are the exclusion of patients with distal ureteral stones and the limited sample size. Conclusions: PSS significantly reduced stent-related symptoms after URS, in particular urinary symptoms and pain, compared to conventional DJ stents, and showed a good safety profile. Patient summary: Stents are hollow tubes placed in the passage between the kidney and the bladder (ureter). The standard stent has two coiled ends (double J stent) to keep it in place in both the kidney and the bladder. We tested a commercial stent with two strings at the bladder end (pigtail suture stent) after procedures to remove stones from the upper urinary tract and found that it caused less stent-related symptoms compared to a double J stent.This trial is registered at Clinicaltrials.gov as NCT03344120. |
topic |
Double J stent Lower urinary tract symptoms Nephrolithiasis Pain Pigtail suture stents Stents |
url |
http://www.sciencedirect.com/science/article/pii/S2666168321000781 |
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