1817 DO URETERAL EXTRACTION STRINGS AFFECT POST-OPERATIVE COMPLICATIONS: RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopy or Percutaneous Stone Removal (III)1 Apr 20131817 DO URETERAL EXTRACTION STRINGS AFFECT POST-OPERATIVE COMPLICATIONS: RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL Kerri Barnes, Megan Bing, and Chad Tracy Kerri BarnesKerri Barnes Iowa City, IA More articles by this author , Megan BingMegan Bing Iowa City, IA More articles by this author , and Chad TracyChad Tracy Iowa City, IA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2180AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteral stent extraction strings may improve patient convenience and lower healthcare costs. This study sought to evaluate patient preference for extraction method and determine whether extraction strings are associated with changes in quality of life, pain, or complications. METHODS Patients scheduled for ureteroscopic stone surgery were approached for potential enrollment in this IRB-approved study. Patients were excluded if they had a pre-operative urinary tract infection (UTI), planned bilateral procedure, pregnancy, or a solitary kidney. Patients were randomized to a stent with or without an extraction string at the conclusion of the procedure. Patients with a string removed their stent at home on post-operative day 7 (POD), while those without a string were scheduled for cystoscopic retrieval POD 7-14. Symptoms were evaluated using the validated Ureteric Stent Symptom Questionnaire (USSQ) on POD 1 and 6. All patients completed a Likert pain survey following stent removal. RESULTS To date, 142 consecutive patients have been approached for enrollment. 52 patients did not meet eligibility criteria, while 46 refused to participate. Of those refusing participation, 37% preferred a string, while 63% did not want an extraction string (20% total cohort). Forty-four patients met all inclusion criteria and were randomized. There was no difference between groups in regards to age, laterality, BMI, or sex. There was no difference in stent related complications (p=0.3) or UTI (p=0.78) between those with and without extraction strings. Three patients (14%) with extraction strings had early dislodgement; however, none of these patients required subsequent replacement. Likewise, there was no differences in urinary symptoms, pain, affect on work or change in global quality of life between patients with or without extraction string (p=0.78, 0.59, 0.98, 0.78, respectively). Nineteen patients (34%) called with postoperative questions, with no difference between those with and without strings (p=0.79). CONCLUSIONS Ureteral stent extraction strings following ureteroscopy do not affect patient quality of life, increase postoperative pain or complications. Extraction strings should be used with caution who have imperative indications for stenting as up to 14% of patients may prematurely dislodge their stent. Continued enrollment of patients in the study is needed to determine if there are more subtle differences among groups. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e747 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kerri Barnes Iowa City, IA More articles by this author Megan Bing Iowa City, IA More articles by this author Chad Tracy Iowa City, IA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...