In their initial experience, Vogt et al. compared stent-related symptoms (SRS) in 24 patients undergoing DJ substitution with a self-made PSS. No subsequent studies have investigated this scenario, nor have commercially available PSS ever been involved in this setting.
Hence, we conducted a prospective multicenter longitudinal trial to evaluate patients undergoing DJ substitution with a commercially available PSS (JFil®—Rocamed, Monaco, MC) after ureteroscopy (URS) for stone treatment, comparing symptoms related to the two different devices.3 Reasons for primary DJ placement were renal colic with concomitant urinary tract infection and unsuccessful attempts at primary URS.
To the best of our knowledge, this trial is the first on the topic of providing longitudinal data concerning PSS in pre-stented patients. Ninety-three patients were enrolled and underwent surgery at two Italian University Hospitals (AOU Città della Salute e della Scienza, Molinette University Hospital, Turin - AOU University Hospital, Parma). SRS was assessed using the Ureteral Stent Symptoms Questionnaire (USSQ), which was administered three times: 2 weeks after DJ, 2 weeks after PSS, and 4 weeks after PSS removal (baseline).4
Results showed significantly better scores in terms of urinary symptoms, pain, work performance, and quality of life in favor of PSS, both considering USSQ scores and individual USSQ answers. Moreover, the rate of patients reporting pain was significantly lower for PSS. Pain Index Score and VAS were comparable to baseline with PSS, while significantly different with DJ.
This study demonstrates that this type of PSS can reduce the impact of SRS in patients already fitted with a DJ. Since stent insertion after URS seems to be commonplace,5 urologists may consider inserting PSS not only in naive patients but also in pre-stented patients: PSS leads to a reduction in SRS and better quality of life compared to DJ, and it also has an inferior impact on social life and work performance.
Written by:
- Andrea Bosio, MD, PhD, FEBU, Department of Urology, AOU Città della Salute e della Scienza, Molinette University Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy
- Eugenio Alessandria, MD, FEBU, Department of Urology, AOU Città della Salute e della Scienza, Molinette University Hospital, Turin, Italy
- Vogt B, Desgrippes A, Desfemmes FN. Changing the double-pigtail stent by a new suture stent to improve patient's quality of life: a prospective study. World J Urol. 2015 Aug;33(8):1061-8.
- Bosio A, Alessandria E, Agosti S, Vitiello F, Vercelli E, Bisconti A, Piana P, Fop F, Gontero P. Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial. Eur Urol Open Sci. 2021 May 10;29:1-9.
- Bosio A, Ferretti S, Alessandria E, Vitiello F, Vercelli E, Campobasso D, Micai L, Gozzo C, Bertello G, Guarino GG, Alice C, Bisconti A, Fop F, Gontero P. Patients undergoing double J substitution with a pigtail suture stent report a significant decrease of stent-related symptoms. Results from a prospective multicenter longitudinal trial. World J Urol. 2024 Mar 22;42(1):186.
- Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol. 2003 Mar;169(3):1060-4.
- Pereira JF, Bower P, Jung E, Parkhomenko E, Tran T, Thavaseelan S, Pareek G. Ureteral stenting practices following routine ureteroscopy: an international survey. World J Urol. 2019 Nov;37(11):2501-2508.