Impact of ureteral stenting in ureteroscopy.

Abstract

We review new therapies and biomaterials designed to reduce ureteral stent symptoms in patients undergoing ureteroscopy. Pharmacologically, alpha blockers and antimuscarinics have been shown to have a synergistic effect and be more effective than either medication alone in reducing stent-related symptoms. Prestenting patients prior to ureterosocpy has been shown to be beneficial for patients with renal stones, offering a better stone-free rate and reduced complications, but not for ureteral stones. Stenting after use of a ureteral access sheath reduced complications and unscheduled emergency visits. Nonsteroidal anti-inflammatories have been shown to prevent pain after stent removal. Surveys showed that patients preferred to remove their own stents via dangle strings at home or undergo cystoscopic removal in the operating room with some type of anesthesia. New materials such as gel-based or biodegradable ureteral stents are being developed to deal with stent-related pain, encrustation, and infection. Antirefluxing stents eliminate vesicoureteric reflux in patients during voiding and may reduce symptoms of back and flank pain. Ureteral stents are involved in many procedures in urology and particularly kidney stone treatments. Advances in materials and medications will help improve the patient experience for those who receive a ureteral stent.