Changing the double-pigtail stent by a new suture stent to improve patient’s quality of life: a prospective study

PURPOSE: Double-pigtail stent intolerance reduces patient’s quality of life. By decreasing the amount of material within the bladder, it should be possible to attenuate stent’s symptoms. We evaluated the tolerance of a new stent with a dedicated questionnaire. METHODS: The major innovation of the pigtail suture stent (PSS) is in the replacement of the lower part of the double-pigtail stent with a 0.3F suture. A total of 79 consecutive patients agreed to be fitted with a PSS. The double-pigtail stents of 24 patients complaining strongly of symptoms were replaced with PSS (group 1), and 55 other patients were fitted directly with the PSS after an ureteral endoscopic intervention (group 2). The questionnaire was prospectively administered to patients at baseline and Day 15 post-placement. RESULTS: All questionnaires were returned. In group 1, the replacement of the double-pigtail stent with a PSS significantly decreased urinary symptom scores (35.2 ± 7.5 vs. 23.6 ± 5.4; p = 2 × 10(−6)) and pain scores (11.0 ± 3.9 vs. 4.9 ± 3.1; p = 1 × 10(−7)). In group 1, the baseline scores were not significantly different from those of control group with double-pigtail stent. In group 2, the urinary scores with PSS were significantly different from those of baseline without stent. The scores of the two groups fitted with a PSS were not significantly different at Day 15 post-placement. Unexpectedly, following PSS implantation, we observe a clear dilation of the ureter without inflammation around the suture. CONCLUSIONS: The PSS significantly decreases stent’s symptoms and constitutes a medical advance in the domain of ureteral stent tolerance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00345-014-1394-2) contains supplementary material, which is available to authorized users.