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Risk Factors for Increased Stent-associated Symptoms Following Ureteroscopy for Urinary Stones: Results From STENTS.
Harper, Jonathan D; Desai, Alana C; Maalouf, Naim M; Yang, Hongqiu; Antonelli, Jodi A; Tasian, Gregory E; Lai, H Henry; Reese, Peter P; Curatolo, Michele; Kirkali, Ziya; Al-Khalidi, Hussein R; Wessells, Hunter; Scales, Charles D.
Afiliación
  • Harper JD; Department of Urology, University of Washington, Seattle, Washington.
  • Desai AC; Department of Surgery (Urologic Surgery), Washington University in St Louis, St Louis, Missouri.
  • Maalouf NM; Department of Internal Medicine and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas.
  • Yang H; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
  • Antonelli JA; Department of Surgery (Urology), Duke Surgical Center for Outcomes Research & Equity in Surgery, Duke University School of Medicine, Durham, North Carolina.
  • Tasian GE; Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Lai HH; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
  • Reese PP; Department of Surgery (Urologic Surgery), Washington University in St Louis, St Louis, Missouri.
  • Curatolo M; Department of Anesthesiology, Washington University in St Louis, St Louis, Missouri.
  • Kirkali Z; Department of Medicine, Renal Division, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Al-Khalidi HR; Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington.
  • Wessells H; National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
  • Scales CD; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
J Urol ; 209(5): 971-980, 2023 05.
Article en En | MEDLINE | ID: mdl-36648152
PURPOSE: The STudy to Enhance uNderstanding of sTent-associated Symptoms sought to identify risk factors for pain and urinary symptoms, as well as how these symptoms interfere with daily activities after ureteroscopy for stone treatment. MATERIALS AND METHODS: This prospective observational cohort study enrolled patients aged ≥12 years undergoing ureteroscopy with ureteral stent for stone treatment at 4 clinical centers. Participants reported symptoms at baseline; on postoperative days 1, 3, 5; at stent removal; and day 30 post-stent removal. Outcomes of pain intensity, pain interference, urinary symptoms, and bother were captured with multiple instruments. Multivariable analyses using mixed-effects linear regression models were identified characteristics associated with increased stent-associated symptoms. RESULTS: A total of 424 participants were enrolled. Mean age was 49 years (SD 17); 47% were female. Participants experienced a marked increase in stent-associated symptoms on postoperative day 1. While pain intensity decreased ∼50% from postoperative day 1 to postoperative day 5, interference due to pain remained persistently elevated. In multivariable analysis, older age was associated with lower pain intensity (P = .004). Having chronic pain conditions (P < .001), prior severe stent pain (P = .021), and depressive symptoms at baseline (P < .001) were each associated with higher pain intensity. Neither sex, stone location, ureteral access sheath use, nor stent characteristics were drivers of stent-associated symptoms. CONCLUSIONS: In this multicenter cohort, interference persisted even as pain intensity decreased. Patient factors (eg, age, depression) rather than surgical factors were associated with symptom intensity. These findings provide a foundation for patient-centered care and highlight potential targets for efforts to mitigate the burden of stent-associated symptoms.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cálculos Ureterales / Cálculos Urinarios / Urolitiasis Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Urol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cálculos Ureterales / Cálculos Urinarios / Urolitiasis Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Urol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos