Stent-Associated Symptoms After Two-Stage Ureteroscopy: Results From STENTS - 04/12/25

Doi : 10.1016/j.urology.2025.11.228

Daniel Garrett Wong ^a, Jonathan D. Harper ^b, Naim M. Maalouf ^c, Joel Vetter ^a, Hussein R. Al-Khalidi ^d,^e, H. Henry Lai ^a,^f, Brett A. Johnson ^g, Charles D. Scales ^d,^h, Ziya Kirkali ⁱ, Alana C. Desai ^a,^b,^⁎

for the USDRN Investigators

^a Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, MO

^b Department of Urology, University of Washington School of Medicine, Seattle, WA

^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 Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC

^f Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO

^g Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX

^h Departments of Urology and Population Health Sciences, 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., University of Washington Medical Center, Department of Urology, Box 356510, 1959 NE Pacific St. Seattle, WA 98196. University of Washington Medical Center, Department of Urology Box 356510, 1959 NE Pacific St. Seattle WA 98196

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 04 December 2025

Abstract

Objective

To compare patient-reported stent-associated symptoms (SAS) after first- and second-stage unilateral ureteroscopy with ureteral stent placement for treatment of urinary stones.

Methods

Participants enrolled in the Study to Enhance Understanding of Stent-Associated Symptoms (STENTS) underwent unilateral URS with a ureteral stent for urinary stones and completed patient-reported outcome measures to assess SAS. Differences in pain intensity were evaluated at baseline and following first- and second-stage URS procedures. A propensity score–matched cohort of participants who underwent single-stage URS was compared to participants undergoing a two-staged procedure.

Results

Of the 424 participants who underwent unilateral URS, 40 (9.4%) had an unplanned staged procedure. Most participants (75%) undergoing a staged procedure had a narrow ureter or stricture. The median time to the second procedure was 14.0 days, with the second procedure mean operative time 25 min greater than the first stage. Preoperative pain intensity was similar before both procedures, whereas postoperative pain was lower after the second procedure compared to the first. In the matched cohort, patients reported comparable pain on POD 1, but lower pain scores in the two-stage group on PODs 3 and 5. Urinary symptoms were improved on PODs 1 and 3 after the second procedure compared to the first stage.

Conclusion

Despite a longer procedure time, pain intensity appears to be lower after a second-stage procedure compared to the first. These results may be useful in counseling patients who require staged treatment.

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