Study On Factors Responsible For Stent-related Symptoms In Patients With Indwelling Ureteral Stent

Objective:To determine the factors responsible for stent-related symptoms in patients with indwelling ureteral stent,and to provide the theoretical basis for clinicians while treating ureteral stent-related symptoms.Methods:From June 2021 to January 2023,patients with unilateral renal calculi or ureteral calculi who underwent ureteroscopic holmium laser lithotripsy and indwelling ureteral stents in the Department of Urology,Shanxi Bethune Hospital were studied.The patients’gender,age,BMI,side of ureteral stent,type of ureteral stent,and whether the distal coil of ureteral stent crossing the midline of bladder,whether the distal coil of ureteral stent crossing the upper edge of pubic symphysis were collected through clinical data.And using the Chinese version of the Ureteral Stent Symptom Questionnaire(USSQ)to investigate the patients.The patients’gender,age,BMI,side of ureteral stent placement,type of ureteral stent,whether the distal coil of the ureteral stent crossing the midline of the bladder,and whether the distal coil of the ureteral stent crossing the upper edge of the pubic symphysis were used as independent variables.The scores of Urinary symptoms,Body pain,General health,and Additional problems in the Chinese version of USSQ were used as dependent variables.Single factor analysis was performed using SPSS22.0,then multiple linear regression analysis was performed on factors with statistical significance in single factor analysis to determine the factors responsible for stent-related symptoms in patients with indwelling ureteral stent.Results:1.A total of 177 patients were included.(1)Male group(107,60.5%)and female group(70,39.5%).(2)<60 years old group(146,82.5%)and≥60 years old group(31,17.5%).(3)Obese group(BMI≥28kg/m~2,83,46.9%)and non-obese group(BMI<28kg/m~2,94,53.1%).(4)Left ureteral stent group(102,57.6%)and right ureteral stent group(75,42.4%).(5)Polaris?Ultra group(137,77.4%)and Percuflex?Plus group(40,22.6%).(6)The distal curl of the ureteral stent crossing the midline of the bladder group(102,57.6%)and the distal curl of the ureteral stent not crossing the midline group(75,42.4%).(7)The distal curl of the ureteral stent crossing the upper edge of the pubic symphysis group(53,29.9%)and the distal curl of the ureteral stent not crossing the upper edge of the pubic symphysis group(124,70.1%).2.The frequency of ureteral stent-related symptoms was stent-related pain(85.3%),urgency(78.5%),frequent urination(75.1%),dysuria(66.1%),hematuria(66.1%),nocturia(47.5%),incomplete urination(19.8%),urinary incontinence(17.5%).The most common site of ureteral stent-related pain was the bladder area(68.2%),followed by the kidney area of the waist and back(49.7%),the groin area(34.4%),and the kidney area in front of the body(7.9%).3.Univariate analysis showed that gender,age,BMI and ureteral stent side had no statistically significant effect on the four aspects of urinary system symptoms,physical pain,general health condition,and additional problems in USSQ(P>0.05).The influence of ureteral stent types on urinary system symptoms and body pain was statistically significant(P<0.05).Whether the distal curl of the ureteral stent crossed the midline of the bladder and whether the distal curl of the ureteral preparation crossed the upper edge of the pubic symphysis had statistically significant effects on the aspects of urinary system symptoms,body pain,general health condition and additional problems(P<0.05).Multivariate linear regression analysis showed that the type of ureteral stent had a statistically significant effect on the urinary system symptoms of USSQ(P<0.05).Whether the distal curl of the ureteral stent crosses the midline of the bladder and whether the distal curl of the ureteral stent crosses the upper edge of the pubic symphysis has a statistically significant impact on the aspects of urinary system symptoms,body pain,general health condition and additional problems(P<0.05).Conclusion:1.The type of ureteral stent,the position of the distal curl of the ureteral stent relative to the midline of the bladder,and the position of the distal curl of the ureteral stent relative to the upper edge of the pubic symphysis are risk factors for stent-related symptoms in patients.2.To reduce the occurrence of stent-related symptoms in patients,clinicians should choose a ureteral stent with soft distal curl when implanting a ureteral stent for patients,and should try to implant the distal curl of the stent near the ureteral orifice of the affected side to avoid it crossing the midline of the bladder and the upper edge of the pubic symphysis.