Associations between ureteral stent indwelling time, patient characteristics, and stent pain from an international prospective registry

Abstract

Objectives: Previous studies have shown conflicting results concerning the optimal duration of ureteral stenting after endourologic treatment of stone disease, its effect on patient comfort, and the necessity for emergent, unscheduled care. This study assessed the impact of stent duration, sex, and other patient-associated factors on reported pain scores using a large, international prospective registry.

Methods: A prospective observational patient registry on ureteral stents from 10 institutions in 4 countries (United States, Canada, France, and Japan) from 2020-2023 was assessed. The primary outcome was Patient-Reported Outcomes Measurement Information System (PROMIS) pain intensity scores administered on the day of stent removal, before stent removal. Patients were grouped by indwelling time (short, medium, and long), and pain scores were compared. The impact of sex, height vs. stent length, and presence or absence of tether were assessed.

Results: 359 patients were enrolled in the database, with outcomes analyzed for 268 patients with a unilateral stent placed after an endourologic procedure for stones. No significant difference was detected in pain scores between the indwelling time groups (p = 0.41). Height for a given stent length was not significantly associated with pain scores. There was no difference in pain scores with or without tether. Men reported lower pain scores than women (p = 0.018).

Conclusions: This study did not detect an overall difference in pain scores reported at stent removal within or between stent duration groups. Men reported less pain than women in this study, suggesting that patient factors may be more important than indwelling time when optimizing pain management.

Keywords: indwelling time; pain; sex; stone management; ureteral stent symptoms.