Investigators evaluate stent use in patients with upper ureteral and kidney stones

In this video, Christopher Allam, MD, discusses the background and notable findings from the recent Journal of Endourology study, “The Role of Routine Ureteral Stenting Following Uncomplicated Ureteroscopic Treatment for Upper Ureteral and Renal Stones: A Randomized Control Trial.” Allam is program director of the SAUSHEC Urology Residency, urology consultant to the Air Force Surgeon General, Director of Air Force Endourology, Laparoscopic, and Robotic Surgery, and an assistant professor of surgery at Uniformed Services University of the Health Sciences in Bethesda, Maryland.

Transcript:

Please describe the background for this study.

I'm an endourologist and I do a lot of stones. I noticed during residency and fellowship, and even early in my clinical practice that oftentimes patients mostly complained of their stent following surgery. There have been some studies that had looked at distal ureteral stones and alleviating the need for stents, and patients seemed to do fine. So I thought, [what about] proximal ureteral stones and kidney stones? Do we need to use ureteral stents following those? There's this perceived idea that there's some ureteral edema, especially if you're up in the kidney treating stones, and therefore we would need to leave a stent. I wanted to develop a study that asked, is it necessary? How do patients do, and what is their comfort level? [That] is why I used the Ureteral Stent Symptom Questionnaire during the study.

What were some of the notable findings? Were any of them surprising to you and your coauthors?

Our hypothesis was that patients were probably going to be more comfortable without a stent. And really, what we wanted to see were the complications and the short-term clinic follow-up or unexpected follow-ups. And it was what we thought it was going to be. Based off the questionnaire, [there was] statistically significant worsening quality of life, increased pain, and [increased] pain medicine requirement with a stent compared to without a stent. It was nice to have that kind of objective data from the questionnaire. We did not find any difference in our complication rate or unexpected ER or clinic visits. So it was kind of what we were thinking and what we were hoping, but it was nice to see that in the in the data.

This transcript was edited for clarity.