Randomized evaluation of ureteral stents using validated symptom questionnaire

Background and Purpose: Ureteral stents are associated with significant pain and urinary symptoms. Manufacturers have altered stent designs and materials in an attempt to minimize this morbidity. This study evaluated the impact of these modifications. Patients and Methods: Stent manufacturers were asked to provide the 6F ureteral stent they believed would be associated with the least patient discomfort. Patients undergoing uncomplicated ureteroscopy were randomized to the Bard Inlay, Cook Endo-Sof, Microvasive Contour, Applied Medical Vertex, or Surgitek Classic Double-Pigtail stent. The Ureteric Stent Symptom Questionnaire (USSQ) was administered on days 1, 3, and 5, and the patients maintained a narcotic diary. The data were analyzed using ANOVA and nonparametric methods. Results: A total of 44 patients (73%) completed all USSQ questionnaires. Urinary symptom scores were significantly lower for the Inlay stent on day 3 than for the Vertex (P = 0.01), Contour (P = 0.05), Endo-Sof (P = 0.03), and Classic (P = 0.02) stents. No significant differences were noted in pain and general symptom scores or narcotic use. Conclusions: The Bard Inlay stent is associated with less-severe urinary symptoms than other ureteral stents. The USSQ is a sensitive tool to measure differences between stents.