Risk Factors for Increased Stent-associated Symptoms Following Ureteroscopy for Urinary Stones: Results From STENTS
Jonathan D. Harper, Alana Desai, Naim M. Maalouf, Hongqiu Yang, Jodi Antonelli, Gregory E. Tasian, H. Henry Lai, Peter P. Reese, Michele Curatolo, Ziya Kırkalı, Hussein R. Al‐Khalidi, Hunter Wessells, Charles D. Scales, Peter P. Reese, Gregory E. Tasian, Justin B. Ziemba, Emily Funsten, Adam Mussell, Rebecca McCune, Salima Shah, Arushi Jain, Antoine Selman-Fermin, Naim M. Maalouf, Jodi Antonelli, Brett A. Johnson, Margaret S. Pearle, Linda A. Baker, Brooke Piskator, Joyce Obiaro, Cynthia Rangel, Martinez Hill, Jonathan D. Harper, Hunter Wessells, Michele Curatolo, Todd L. Edwards, Mathew D. Sorensen, Robert A. Sweet, Tristan Baxter, Holly Covert, Elsa Ayala, Lisa Flint, Grace Cho, Grace Marshall, Alana Desai, H. Henry Lai, Kefu Du, Susan Mueller, Linda L. Black, Aleksandra Klim, Charles D. Scales, Hussein R. Al‐Khalidi, Amy Corneli, Bryce B. Reeve, Kevin Weinfurt, Hongqiu Yang, Davy Andersen, Laura A. Johnson, Andrew Dodd, Omar Thompson, Carrie Dombeck, Kevin McKenna, Teri Swezey, Ziya Kırkalı, Christopher W. Mullins
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: < .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.