Ureteral stent discomfort: Etiology and management

OBJECTIVES: To review the evidence-based literature on the causes, characteristics, and options to manage double J stent-related symptoms. METHODS: We performed a Medline database assessment on papers that investigated the prevalence, mechanisms, risk factors, bothersome and management of double-J stent-related symptoms. Articles in English were reviewed and summarized. RESULTS: Stent-related symptoms have a high prevalence and may affect over 80% of patients. They include irritative voiding symptoms including frequency, urgency, dysuria, incomplete emptying; flank and suprapubic pain; incontinence, and hematuria. Assessment tools are important to determine their intensity and allow for comparisons between different points in the timeline. The Urinary Stent Symptom Questionnaire (USSQ) is the most proper tool used for this purpose. Management should be focused on the prevention and management of symptoms. In this sense, research has focused on new materials and stent designs that would be more compatible to the physiologic properties of the urinary tract and medications that can ameliorate the sensitivity and motor response of the bladder. CONCLUSIONS: Stent-related symptoms are very common in the Urological clinical setting. It is of major importance for the urologist to understand their physiopathology and to be familiar with ways to avoid or manage them.