Journal article
Reduction of stent-associated morbidity by minimizing stent material: A prospective, randomized, single-blind superiority trial assessing a customized "Suture-Stent".
- Betschart P Department of Urology, Cantonal Hospital St, Gallen St. Gallen, Switzerland.
- Piller A Department of Urology, Cantonal Hospital St, Gallen St. Gallen, Switzerland.
- Zumstein V Department of Urology, Cantonal Hospital St, Gallen St. Gallen, Switzerland.
- Schmid HP Department of Urology, Cantonal Hospital St, Gallen St. Gallen, Switzerland.
- Engeler DS Department of Urology, Cantonal Hospital St, Gallen St. Gallen, Switzerland.
- Güsewell S Clinical Trials Unit, Cantonal Hospital St, Gallen St. Gallen, Switzerland.
- Pratsinis M Department of Urology, Cantonal Hospital St, Gallen St. Gallen, Switzerland.
- Abt D Department of Urology, Cantonal Hospital St, Gallen St. Gallen, Switzerland.
- 2020-11-05
Published in:
- BJU international. - 2020
English
OBJECTIVES
To compare a customized Suture-Stent with a standard ureteral stent regarding stent-related symptoms, safety and efficacy.
MATERIALS AND METHODS
Patients with urolithiasis located proximal to the iliac vessel crossing requiring stenting for preparation of secondary URS were randomized to standard ureteral stenting or a Suture-Stent. Secondary ureterorenoscopy was performed 2-6 weeks later. The Ureteral Stent Symptoms Questionnaire was completed after one week, at the day before URS and 2-6 weeks after stent removal. Stent efficacy and safety were systematically assessed.
RESULTS
Totally 88 patients were included to the analysis. Median Suture-Stent length was 10 cm (range 5 - 25 cm) vs. 26 cm for standard stents. Operation time was longer for insertion of the Suture-Stent (24.0 vs. 14.5 min, p<0.001). Patients with a Suture-Stent had a significantly lower USSQ-urinary symptoms score one week after stent insertion adjusted for baseline symptoms by subtracting scores from the final visit without indwelling stent (mean 7.1 vs. 13.7, difference -6.6, 95% CI -3.4 to -9.8, p <0.001). Prior to secondary URS (after 2-6 weeks), baseline-adjusted urinary symptoms (mean 4.7 vs 12.2, difference -7.5, 95% CI -4.5 to -10.4, p <0.001) and pain subscores (11.5 vs 17.6, difference -6.1, 95% CI -0.7 to -11.6, p = 0.004) were significantly lower in the Suture-Stent group. All other USSQ subscores showed no significant differences. Adverse events occurred in 15 patients and similarly frequent in both groups. No significant differences were found between both groups regarding ureteral access during secondary URS.
CONCLUSION
Replacement of the distal part of ureteral stents by a suture can reduce stent-associated symptoms without restrictions regarding secondary stone removal or safety.
To compare a customized Suture-Stent with a standard ureteral stent regarding stent-related symptoms, safety and efficacy.
MATERIALS AND METHODS
Patients with urolithiasis located proximal to the iliac vessel crossing requiring stenting for preparation of secondary URS were randomized to standard ureteral stenting or a Suture-Stent. Secondary ureterorenoscopy was performed 2-6 weeks later. The Ureteral Stent Symptoms Questionnaire was completed after one week, at the day before URS and 2-6 weeks after stent removal. Stent efficacy and safety were systematically assessed.
RESULTS
Totally 88 patients were included to the analysis. Median Suture-Stent length was 10 cm (range 5 - 25 cm) vs. 26 cm for standard stents. Operation time was longer for insertion of the Suture-Stent (24.0 vs. 14.5 min, p<0.001). Patients with a Suture-Stent had a significantly lower USSQ-urinary symptoms score one week after stent insertion adjusted for baseline symptoms by subtracting scores from the final visit without indwelling stent (mean 7.1 vs. 13.7, difference -6.6, 95% CI -3.4 to -9.8, p <0.001). Prior to secondary URS (after 2-6 weeks), baseline-adjusted urinary symptoms (mean 4.7 vs 12.2, difference -7.5, 95% CI -4.5 to -10.4, p <0.001) and pain subscores (11.5 vs 17.6, difference -6.1, 95% CI -0.7 to -11.6, p = 0.004) were significantly lower in the Suture-Stent group. All other USSQ subscores showed no significant differences. Adverse events occurred in 15 patients and similarly frequent in both groups. No significant differences were found between both groups regarding ureteral access during secondary URS.
CONCLUSION
Replacement of the distal part of ureteral stents by a suture can reduce stent-associated symptoms without restrictions regarding secondary stone removal or safety.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1111/bju.15290
- PMID 33152169
- Persistent URL
- https://sonar.ch/global/documents/159157
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