Comparison of Stent-Related Symptoms Between Conventional Double-J Stents and a New-Generation Thermoexpandable Segmental Metallic Stent: A Validated-Questionnaire-Based Study

Abstract

Double-J stents revolutionized the minimally invasive management of ureteral strictures, but have significant morbidity. We compare stent-related symptoms and quality of life between a conventional Double-J stent and a novel thermoexpandable metal segmental ureteral stent (Memokath) in patients with ureteral strictures. Seventy patients with a conventional Double-J stent or a Memokath stent for ureteral strictures were mailed a validated ureteral stent symptom questionnaire, which is a multidimensional measure that evaluates stent-related morbidity in six sections: urinary symptoms, body pain, general health, work performance, sexual matters, and additional problems. Statistical analysis compared the differences in these parameters between the two groups. Forty-one patients (58.5%) responded, 23 with a Double-J stent and 18 with a Memokath stent. A subgroup of 10 patients had both a Double-J and a Memokath stent. Nearly 70% of patients with Double-J stents experienced urine frequency <or=2 hours versus 47% with Memokath stents. About 31.8% of patients with Double-J stents were extremely bothered by urinary symptoms versus 5.6% with Memokaths. About 66.7% of patients with Double-J stents had a negative view toward living with their current urinary symptoms versus 35.3% with Memokath stents. The ureteral stent symptom questionnaire revealed that pain, urinary symptoms index, and general health were statistically better in the Memokath group. The Memokath group significantly outperformed the Double-J stent group in terms of the light and heavy activity. In terms of future stent insertion, patients preferred the Memokath stent. In the subgroup who had experienced both stents, the Memokath questionnaire revealed improvements in the domain of pain and the lower urinary tract symptoms index, though this was not statistically significant. This may reflect the small size of the study population. There were improvements in general health and other quality-of-life parameters, and there was a tendency in favor of the Memokath.