Abstract
Background Ureteral stent intolerance reduces patients' quality of life. It has been suggested that changes in the shape of stents could decrease discomfort. In previous studies, the innovative pigtail-suture stent (i.e., JFil® or MiniJFil®) with a thin 0.3 F suture thread significantly decreased stent-related symptoms. Fortuitously, a dilation of the ureter containing the sutures was discovered. In addition, no inflammation was seen on the ureter wall around the suture in endoscopy. In this preliminary study, we assessed ureteral inflammation in the human ureter when it was healthy or when fitted with a double-pigtail stent or a thread. Materials and Methods After consent and inclusion of patients in the protocol, fifteen segments of ureters were collected during cystectomy procedures for bladder tumors. Ureteral inflammation was assessed on the histological section stained with hematoxylin-eosin. Histological grading (cumulative range of 0 to 6) assessing inflammation was performed on the ureter section for mucosa inflammation and inflammation in the muscle layer. Results A marked ureteral inflammatory reaction was observed in all cases of ureters fitted with a double-pigtail stent with a mean inflammation score of 4.8 ± 0.4. The ureter fitted with the thin suture thread showed inflammation in only one case with a mean inflammation score of 1.8 ± 1.3 (p=0.001). Conclusion Although the study was limited by the small number of patients, it confirmed that the double-pigtail stent induced ureteral inflammation in all cases and the thin 0.3 F suture thread caused less ureteral inflammation than the double-pigtail stent. The concept of material reduction within the urinary tract seems necessary in order to decrease mucosal irritation. The JFil® or the MiniJFil® thread could meet this requirement.
Highlights
Double-pigtail stents are frequently implanted in the ureter in urological practice, but ureteral stent intolerance reduces patients’ quality of life. e symptoms may be largely due to bladder irritation caused by the stent and by the reflux during bladder voiding [1].By decreasing the amount of material within the bladder, it should be possible to attenuate the stent-related symptoms [2,3,4].To minimize the amount of material left in the bladder, a® ® pigtail-suture stent (i.e., JFil or MiniJFil ) was evaluated [2, 5]
The study was limited by the small number of patients, the use of a semiquantitative scale made it possible to specify the alterations of the ureteral wall less subjectively
The small number of patients requires more targeted studies but, if gathering the ureteral segment fitted with a doublepigtail stent is feasible, it is exceptionally rare for a ureter with a thin thread because cystectomy is the only indication
Summary
Ureteral stent intolerance reduces patients’ quality of life. It has been suggested that changes in the shape of stents. The innovative pigtail-suture stent (i.e., JFil or MiniJFil ) with a thin 0.3 F suture thread significantly decreased stent-related symptoms. No inflammation was seen on the ureter wall around the suture in endoscopy. In this preliminary study, we assessed ureteral inflammation in the human ureter when it was healthy or when fitted with a double-pigtail stent or a thread. A marked ureteral inflammatory reaction was observed in all cases of ureters fitted with a double-pigtail stent with a mean inflammation score of 4.8 ± 0.4. E ureter fitted with the thin suture thread showed inflammation in only one case with a mean inflammation score of 1.8 ± 1.3 (p 0.001). ® ® within the urinary tract seems necessary in order to decrease mucosal irritation. e JFil or the MiniJFil thread could meet this requirement
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