Üreteral stent ilişkli semptomlarda 4.0 Fr’e karşın 4.8 Fr double J stentler: ankete dayalı karşılaştırmalı bir çalışma

Yıl 2023, Cilt: 16 Sayı: 4, 610 - 616, 01.10.2023

Hakan Anıl , Umut Ünal , Ahmet Guzel

https://doi.org/10.31362/patd.1339270

Öz

Amaç: Farklı ureteral stent çaplarının (4.0 Fr-4.8 Fr) kullanımıyla Üreteral Stentle İlişkili Semptom Anketi (USSQ) skorlarındaki farkı araştırmaktır.
Gereç ve yöntem: Ağustos 2022 ile Ocak 2023 tarihleri arasında iki farklı merkezde endoskopik üreter taşı ve retrograd intrarenal cerrahi sonrası double J stent takılan hastalar çalışmaya dahil edildi. Hastalar 4.0 Fr ve 4.8 Fr stent boyutlarına göre iki gruba ayrıldı. Hastaların tamamı taburcu olduktan sonraki 2. haftada kontrole çağrıldı ve USSQ ile sorgulandı.
Bulgular: Çalışmaya 4.0 Fr grubunda 112, 4.8 Fr grubunda 116 olmak üzere toplam 228 hasta dahil edildi. 2. hafta kontrolünde toplam USSQ ölçek puanları 4.0 Fr ve 4.8 Fr grupları için sırasıyla 73.9±8.9 ve 80.0±9.8 idi (p<0.001). 4.0 Fr grubunda 10 (%8.1), 4.8 Fr grubunda 3 (%2.5) hastada stent dislokasyonu saptandı (p=0.049). Belirti puan ölçeği alt alanlara göre ayrı ayrı analiz edilmiştir. İdrar indeks skorunun ortalama değeri 4.0 Fr grubu için 24.5±3.6 ve 4.8 Fr grubu için 27.6±3.4 idi (p<0.001). Vücut ağrı indeksi skoru 4.0 Fr ve 4.8 Fr grupları için sırasıyla 16.4±3.8 ve 18.6±3.8 idi (p<0.001). Genel sağlık indeksi skoru, iş performansı indeks skoru ve cinsel hususlar skoru gruplar arasında istatistiksel olarak anlamlı farklılık göstermedi.
Sonuç: Çalışmamız üreteral stent ilişkili semptomların 4 Fr üreteral stent lehine olduğunu bildirmektedir. Buna karşılık 4 Fr üreteral stentler daha yüksek migrasyon oranına sahipti.

Anahtar Kelimeler

Üreteral stentler, stent ilişkili semptomlar, USSQ skor, ürolitiyazis, yaşam kalitesi

Ureteral stent-related symptoms in 4.0 Fr versus 4.8 Fr double J stents: a questionnaire-based comparative study

Öz

Purpose: The aim was to investigate the difference in Ureteral Stent-Related Symptom Questionnaire (USSQ) scores with the use of different stent diameters (4.0 Fr versus 4.8 Fr).
Materials and methods: Between August 2022 and January 2023, patients with double J stent insertion after endoscopic ureteral stone and retrograde intrarenal surgery in two different centers were included in the study. The patients were divided into two groups according to stent size of 4.0 Fr and 4.8 Fr. All of the patients were called for check-ups in the 2nd week after discharge and were questioned using the USSQ.
Results: A total of 228 patients, 112 in the 4.0 Fr group and 116 in the 4.8 Fr group, were included in the study. At the 2nd week visit, the total USSQ scale scores were 73.9±8.9, and 80.0±9.8 for the 4.0 Fr and 4.8 Fr groups, respectively (p<0.001). Stent dislocation was detected in 10 (8.1%) patients in the 4.0 Fr group and in 3 patients (2.5%) in the 4.8 Fr group (p=0.049). The symptom score scale was analyzed separately based on subdomains. The mean value for the urinary index score was 24.5±3.6 for the 4.0 Fr group and 27.6±3.4 for the 4.8 Fr group (p<0.001). Body pain index score was 16.4±3.8 and 18.6±3.8 for the 4.0 Fr and 4.8 Fr groups, respectively (p<0.001). The general health index score, work performance index score, and sexual matter score were not statistically significantly different between the groups.
Conclusion: Our study reported that ureteral stent-related symptoms favor the 4 Fr ureteral stent. In contrast, 4 Fr ureteral stents had a higher migration rate.

Anahtar Kelimeler

Ureteral stents, stent-related symptoms, USSQ score, urolithiasis, quality of life

Kaynakça

• 1. Muslumanoglu AY, Fuglsig S, Frattini A, et al. Risks and benefits of postoperative double-j stent placement after ureteroscopy: results from the clinical research office of endourological society ureteroscopy global study. J Endourol 2017;31:446-451. https://doi.org/10.1089/end.2016.0827
• 2. Sali GM, Joshi HB. Ureteric stents: overview of current clinical applications and economic implications. Int J Urol 2020;27:7-15. https://doi.org/10.1111/iju.14119
• 3. Türk C, Petřík A, Sarica K, et al. EAU Guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 2016;69:468-74. https://doi.org/10.1016/j.eururo.2015.07.040
• 4. Giannarini G, Keeley Jr FX, Valent F, et al. Predictors of morbidity in patients with indwelling ureteric stents: results of a prospective study using the validated Ureteric Stent Symptoms Questionnaire. BJU Int 2011;107:648-654. https://doi.org/10.1111/j.1464-410X.2010.09482.x
• 5. Scales CD Jr., Saigal CS, Hanley JM, et al. The impact of unplanned postprocedure visits in the management of patients with urinary stones. Surgery 2014;155:769-775. https://doi.org/10.1016/j.surg.2013.12.013
• 6. 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;169:1060-1064. https://doi.org/10.1097/01.ju.0000049198.53424.1d
• 7. Diatmika AANO, Djojodimedjo T, Kloping YP, Hidayatullah F, Soebadi MA. Comparison of ureteral stent diameters on ureteral stent-related symptoms: a systematic review and meta-analysis. Turk J Urol 2022;48:30-40. https://doi.org/10.5152/tud.2022.21255
• 8. Wu G, Sun F, Sun K, et al. Impact of differential ureteral stent diameters on clinical outcomes after ureteroscopy intracorporeal lithotripsy: a systematic review and meta-analysis. Int J Urol 2021;28:992-999. https://doi.org/10.1111/iju.14631
• 9. Cubuk A, Yanaral F, Ozgor F, et al. Comparison of 4.8 Fr and 6 Fr ureteral stents on stent related symptoms following ureterorenoscopy: a prospective randomized controlled trial. Kaohsiung J Med Sci 2018;34:695-699. https://doi.org/10.1016/j.kjms.2018.07.001
• 10. Nestler S, Witte B, Schilchegger L, Jones J. Size does matter: ureteral stents with a smaller diameter show advantages regarding urinary symptoms, pain levels and general health. World J Urol 2020;38:1059-1063. https://doi.org/10.1007/s00345-019-02829-0
• 11. Damiano R, Autorino R, De Sio M, et al. Does the size of ureteral stent impact urinary symptoms and quality of life? A prospective randomized study. Eur Urol 2005;48:673-678. https://doi.org/10.1016/j.eururo.2005.06.006
• 12. Tanidir Y, Mangir N, Sahan A, Sulukaya M. Turkish version of the Ureteral Stent Symptoms Questionnaire: linguistic and psychometric validation. World J Urol 2017;35:1149-1154. https://doi.org/10.1007/s00345- 016-1958-4
• 13. Fischer KM, Louie M, Mucksavage P. Ureteral stent discomfort and its management. Curr Urol Rep 2018;19:64(e1-7). https://doi.org/10.1007/s11934-018-0818-8
• 14. Cakici MC, Iplikci A, Sendogan F et al. Factors predicting double-j stent migration after retrograde intrarenal surgery. The New J Urol 2021;16:40-46. https://doi.org/10.33719/yud.789879