Data collection involved survey responses of 327 participants across 7 separate academic medical centers in the US and Canada. Variables of interest in the survey included increase pain after stent removal, stent duration, number of prior stones, number of prior stents, patient demographics, health status, timing of last stent, and method of stent removal. Descriptive Statistics were used to summarize survey responses and to indicate factors that led to increase pain after stent removal. Additionally, multiple logistic regression was used to access the effects on stent duration, age, gender, health status, methods of stent removal, and number of prior stents and stones had on the increase pain in the hours after stent removal.
The factors that contributed to increase pain after stent removal and the results of multiple logistic regression can be seen in the following tables (Table 2 and Table 3). In total, 27.3% of patients reported increased pain after ureteral stent removal. Of interest, a higher percentage of females, younger patients, and patients who had stents in place for less than 7 days reported increased pain after stent removal (p<0.001, 0.002, and 0.04 respectively). Multiple logistic regression showed similar results in which patients with stents in place for longer than 7 days and older patients had lower odds of reporting increase pain after stent removal (OR=0.59 and 0.52 respectively), while female patients had higher odds of reporting increased pain after stent removal (OR=2.41).
In his conclusion, the author reiterated that slightly more than 1/4 of patients involved in the study reported increased pain after stent pull, with female patients, younger patients, and patients with shorter stent removals being associated with increased pain. Moving forward, the author proposed a need for pre-stenting counseling and management for these higher risk patient and further research on the appropriate duration of stents placement. Numerous questions arose regarding the need to stent patients after urological procedures given the reported increase pain of shorter stenting, as well as the contribution of NSAIDs and opioids on pain management after stent removal.
Presented by: Michael E. Rezaee MD MPH, Dartmouth-Hitchcock Medical Center
Co-authors: Michael E. Rezaee MD MPH, Annah J. Vollstedt MD, Manoj Monga MD, Amy Krambeck MD, Ojas Shah MD, Roger L. Sur MD, Anna Zampini MD, Kymora B. Scotland MD Ph.D., Ben Chew MD, Brian H. Eisner Md, & Vernon M. Pais Jr. MD
Author Affiliation: Dartmouth-Hitchcock Medical Center
Written by Luke Limfueco, Department of Urology, University of California-Irvine, at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois
Presented by: Michael E. Rezaee MD MPH, Dartmouth-Hitchcock Medical Center
Co-authors: Michael E. Rezaee MD MPH, Annah J. Vollstedt MD, Manoj Monga MD, Amy Krambeck MD, Ojas Shah MD, Roger L. Sur MD, Anna Zampini MD, Kymora B. Scotland MD Ph.D., Ben Chew MD, Brian H. Eisner Md, & Vernon M. Pais Jr. MD
Author Affiliation: Dartmouth-Hitchcock Medical Center
Written by Luke Limfueco, Department of Urology, University of California-Irvine, at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois