The Effect of Ureteral Stents on Postoperative Pain
Öz
Aim: We aimed to assess the postoperative pain after endoscopic ureter stone treatment according to the diameter of double J ureteral stents.
Materials and Methods: Our prospective randomized study included 63 patients with successful operation for unilateral ureter stone and DJ ureteral stent inserted. Patients were divided into 2 subgroups as aged under 40 years and over 40 years. These subgroups were randomized into 4.8 Fr and 6 Fr ureteral DJ stent groups preoperatively in double-blind manner. Patients had pain and other complaints recorded preoperative (preop), postoperative (po) 3rd, 7th days and 1 week after stent removal. Patient pain levels were determined using the numerical pain scale (NPS).
Results: For patients under 40 years of age, Group 1 had preop NPS score of 9.17±0.32, while in Group 2 this was 9.79±0.15 (p=0.099), on po 3rd day NPS scores were 2.50±0.73 and 7.36±0.45 (p<0.05), on po 7th day scores were 1.92±0.53 and 2.57±0.48 (p=0.428), and 1 week after DJ catheter removal scores were 0.08±0.08, 0.57±0.23 (p=0.087), respectively. In both groups over 40 years of age, there were no significant differences in the NPS scores at these times. There were no significant differences identified between the groups for stone size and operation duration.
Conclusions: We think the use of 4.8 Fr DJ catheters after endoscopic ureter stone treatment is more appropriate for pain control in the early po period, especially for young patients under 40 years of age. Additionally, we believe there is a need for more studies related to the necessity for use of ureteral stents and the features that optimal stents should have.
Anahtar Kelimeler
Kaynakça
- Finney RP. Experience with new double J ureteral catheter stent. J Urol. 1978;120(6):678-81.
- Lingeman JE, Preminger GM, Goldfischer ER, Krambeck AE, Team CS. Assessing the impact of ureteral stent design on patient comfort. J Urol. 2009;181(6):2581-7.
- Damiano R, Autorino R, De Sio M, Cantiello F, Quarto G, Perdonà S, et al. Does the size of ureteral stent impact urinary symptoms and quality of life? A prospective randomized study. Eur Urol. 2005;48(4):673-8.
- Auge BK, Sarvis JA, L'Esperance JO, Preminger GM. Practice patterns of ureteral stenting after routine ureteroscopic stone surgery: a survey of practicing urologists. J Endourol. 2007;21(11):1287-92.
- Öztekin Ü, Caniklioğlu M, Sercan S, Gürel A, Selmi V, Işıkay L, et al. Impact of preoperative stent on retrograde intrarenal surgery outcomes. KÜ Tıp Fak Derg. 2020;22(1):89-95.
- Damiano R, Oliva A, Esposito C, De Sio M, Autorino R, D’Armiento M. Early and late complications of double pigtail ureteral stent. Urol Int. 2002;69(2):136-40.
- Miyaoka R, Monga M. Ureteral stent discomfort: Etiology and management. Indian J Urol. 2009;25(4):455-60.
- Jeong H, Kwak C, Lee SE. Ureteric stenting after ureteroscopy for ureteric stones: a prospective randomized study assessing symptoms and complications. BJU international. 2004;93(7):1032-4.
- Joshi H, Newns N, Stainthorpe A, MacDonagh R, Keeley F, Timoney A. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol. 2003;169(3):1060-4.
- Johnson C. Measuring pain. Visual analog scale versus numeric pain scale: what is the difference? J Chiropr Med. 2005;4(1):43.