Stent-associated Symptoms After Two-stage Ureteroscopy: Results From STENTS

To compare patient-reported stent-associated symptoms (SAS) after first- and second-stage unilateral ureteroscopy with ureteral stent placement for treatment of urinary stones.

Participants enrolled in the Study to Enhance Understanding of Stent-Associated Symptoms (STENTS) underwent unilateral URS with a ureteral stent for urinary stones and completed patient-reported outcome measures to assess SAS. Differences in pain intensity were evaluated at baseline and following first- and second-stage URS procedures. A propensity score-matched cohort of participants who underwent single-stage URS was compared to participants undergoing a two-staged procedure.

Of the 424 participants who underwent unilateral URS, 40 (9.4%) had an unplanned staged procedure. Most participants (75%) undergoing a staged procedure had a narrow ureter or stricture. The median time to the second procedure was 14.0 days, with the second procedure mean operative time 25 min greater than the first stage. Preoperative pain intensity was similar before both procedures, whereas postoperative pain was lower after the second procedure compared to the first. In the matched cohort, patients reported comparable pain on POD 1, but lower pain scores in the two-stage group on PODs 3 and 5. Urinary symptoms were improved on PODs 1 and 3 after the second procedure compared to the first stage.

Despite a longer procedure time, pain intensity appears to be lower after a second-stage procedure compared to the first. These results may be useful in counseling patients who require staged treatment.