Stent Syndrome. Does the diameter matter? Results of a randomized trial.

INTRODUCTION: Double-j (DJ) ureteral stents are used for multiple purposes in Urology. Even though they temporize the subsequent treatment of lithiasis, they may cause different symptoms that impact quality of life.

PURPOSE: in this randomized trial we assessed whether the diameter of ureteral stents has an impact on catheter-associated symptoms, and their impact on quality of life.

METHODS: A total of 194 consecutive patients undergoing DJ insertion between December 2018 and December 2022 were prospectively enrolled and divided into three categories: 4.7 Fr (G1, n=71), 6 Fr (G2, n=65), and 7 Fr (G3, n=58). Whitin one week after the DJ placement, patients completed the validated Spanish version of the USSQ (Ureteric Stent Symptoms Questionnaire). Continuous variables were compared using ANOVA and t-student tests. For categorical data, the chi-square test was used.

RESULTS: In the domain of "work" and "additional problems" there were significant differences. In the "Work" domain G1 presented the lower symptoms. In the domain "additional problems" patients in G1, were prescribed fewer antibiotics due to low urinary tract symptoms. In question U4 about urinary incontinence, patients in G2 and G3 developed these symptoms more than patients in G1. In the "sexual activity" domain, specifically in question S3, which emphasizes whether the patient has ever suffered any type of pain during sexual activity, resulting in patients with 4.7 Fr have not had or have had milder symptoms about catheters with a larger diameter.

CONCLUSION: DJ-related symptoms affect quality of life in most cases. Smaller catheters produced significantly less urinary incontinence, faster work reincorporation, fewer symptoms related to sexual activity, and fewer catheter-related symptoms than 7 Fr catheters. In contrast, G3 presented fewer outpatient visits due to symptoms related to the DJ.