Rethinking of ureteral stent removal using an extraction string; what patients feel and what is patients' preference?...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Patient-Reported Outcomes

Background:

• Ureteral stent removal via extraction string can avoid invasive cystoscopy.
• Limited data exists on patient experience and preference for string-assisted removal.
• This study addresses patient perceptions and factors influencing preference for string removal.

Purpose of the Study:

• To evaluate patient preference for ureteral stent removal using an extraction string.
• To identify parameters influencing patient preference for this removal method.

Main Methods:

• 114 patients undergoing ureteral stent insertion post-ureteroscopic stone removal were randomized into string or no-string groups.
• Stent removal occurred within 7 days post-operation.
• Patients completed symptom questionnaires, a visual analog scale (VAS) for pain, and preference questions.

Main Results:

• No significant differences in overall urinary symptoms, pain, general health, or work performance domains.
• Significant differences noted in 'dysuria' and 'difficulties with heavy physical activity'.
• Higher proportion of string group patients reported 'stoppage of sexual intercourse'; lower VAS pain scores during removal in the string group.
• Patients who experienced string removal preferred it over past methods.

Conclusions:

• Patients preferred ureteral stent removal with an extraction string after ureteroscopic stone removal (URS).
• The extraction string method resulted in less pain during stent removal compared to flexible cystoscopic removal.
• Minor increases in morbidity associated with the extraction string were observed.