Predictive factors for ureteral double-J-stent-related symptoms: A prospective, multivariate analysis

Background/Purpose: Whether the length of stent affects stent-related symptoms after urological procedures remains controversial. We aimed to evaluate the predictive factors for stent-related urinary tract symptoms after uncomplicated ureteroscopic lithotripsy (URSL). Methods: We prospectively recruited a total of 59 patients who underwent URSL and 6-Fr double-J ureteral stent placement. The demographic and perioperative data and stent characteristics, including the length (22, 24 or 26 cm), position of proximal end (upper calyx or pelvis), position of distal end (crossing midline or not), and configurations of both ends (complete or incomplete curl) were recorded. All patients completed a self-administered questionnaire to evaluate the stent-related urinary symptoms, bladder pain, flank pain and hematuria 1 week after the procedure. All variables were analyzed by a proportional odds logistic regression model. Results: Twenty-two male (37.3%) and 37 (62.7%) female patients were enrolled in this study. Their mean age was 53.7 ± 12.9 years. The mean body height was 161.9 ± 7.9 cm (range, 145.9-178 cm). In multivariate analysis, the 26-cm stent was independently associated with the severity of frequency, urgency, and nocturia symptoms. Crossing the midline of the distal end was significantly associated with urge incontinence. The 24-cm and 26-cm stents were both very strongly associated with the severity of hematuria. Crossing the midline of the distal end was significantly associated with bladder pain. Conclusion: The length of stent and crossing the midline of the distal end were significantly associated with stent-related symptoms after URSL. Selection of the proper length of double-J stent is the most important factor in minimizing stent-related symptoms.