Postoperative Symptom Severity and Time Course After Bilateral Ureteroscopy With Stents: Results From the Study to Enhance Understanding of Stent-associated Symptoms - 25/09/25

Doi : 10.1016/j.urology.2025.08.057

Alana C. Desai ^a,^b,^⁎ , Jonathan D. Harper ^a, Naim M. Maalouf ^c, Hing Hung Henry Lai ^b, Charles D. Scales ^d,^e,^f, Hongqiu Yang ^d, Gregory E. Tasian ^g, Rebecca D. McCune ^g, Hussein R. Al-Khalidi ^d,^h, Ziya Kirkali ⁱ, Hunter Wessells ^a, Jodi A. Antonelli ^e
^a Department of Urology, University of Washington School of Medicine, Seattle, WA
^b Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, MO
^c Department of Internal Medicine and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX
^d Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
^e Department of Urology, Duke University School of Medicine, Durham, NC
^f Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
^g Division of Urology, Children’s Hospital of Philadelphia and Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
^h Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC
ⁱ National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD

^⁎Address correspondence to: Alana C. Desai, M.D., Department of Urology, University of Washington School of Medicine, Box 356510, 1959 NE Pacific Street, Seattle, WA 98195.Department of Urology, University of Washington School of MedicineBox 356510, 1959 NE Pacific StreetSeattleWA98195

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 25 September 2025

Résumé

Objective

To assess and compare stent-associated symptoms after unilateral vs bilateral ureteroscopy with ureteral stent placement for stone treatment.

Methods

Participants enrolled in the Study to Enhance Understanding of Stent-Associated Symptoms (STENTS), a multicenter, prospective, observational cohort study, completed validated questionnaires and patient-reported outcome measures to assess stent-associated symptoms postoperatively. Patient-Reported Outcomes Measurement Information System (PROMIS) tools were used to measure pain intensity and interference due to pain, while the Ureteral Stent Symptom Questionnaire (USSQ) and Lower Urinary Tract Dysfunction Research Network Symptom Index-10 (LURN SI-10) were used to measure urinary symptoms. These data were used to determine symptom intensity and course, comparing outcomes after bilateral vs unilateral ureteroscopy.

Results

Of the 484 participants who enrolled in STENTS, 60 underwent a bilateral procedure. Patients in the bilateral group reported greater increases in pain intensity and pain interference beginning on POD 3 (P = .017 and .022, respectively), continuing through POD 7-9, with no difference in interference 30 days after stent removal, compared to the unilateral group. Urinary symptoms were worse following a bilateral compared to unilateral procedure at all time points, except for similar urinary symptoms 30 days following stent removal.

Conclusion

Patients undergoing bilateral compared to unilateral ureteroscopy report higher pain intensity, pain interference and urinary symptoms. Although exploratory, this analysis provides the most informative description of the patient experience with bilateral stents to date and may be useful in counseling patients considering bilateral stone treatment and in managing expectations.

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