How does RIRS impact on stent-related symptoms? Insights from a prospective observational study by EAU-YAU...

To assess the perception and severity of stent-related symptoms (SRS) in patients undergoing retrograde intrarenal surgery (RIRS).

A prospective observational study was performed including patients with single or multiple renal stones undergoing ureteral stenting and scheduled for a definitive RIRS. SRS were evaluated at 3 timepoints: pre-operatively on the day of RIRS, as well as on the 1st and 7th postoperative day following RIRS. Bladder pain, back pain, hematuria, urgency, frequency, nocturia, and urge incontinence were evaluated using a visual analog scoring (VAS) system.

A total of 57 patients were included. The patients reported a significant rise in back pain at day 1 after RIRS (mean rank 2.25 on a scale of 0 to 5) compared to preoperative scores (2.06), with a significant decrease at day 7 following RIRS (1.68) (p = 0.003). A similar pattern was observed for bladder pain, frequency and urge incontinence (all p < 0.001). As for urgency and nocturia, these SRS steadily decreased from baseline to day 1, and in turn from day 1 to day 7 after RIRS (p = 0.004 and p = 0.003, respectively). Hematuria was the only SRS which did not show any significant differences over the 3 evaluated timepoints.

RIRS temporarily increases certain SRS, particularly pain and urinary discomfort within the first 24 h postoperatively. These symptoms tend to improve by the 7th postoperative day, suggesting that surgery itself may contribute to the early symptom burden but ultimately facilitates recovery. Further multi-center prospective studies with bigger sample size are warranted to confirm our findings.