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Ureteral Stent Discomfort and Its Management

  • Endourology (P Mucksavage, Section Editor)
  • Published:
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Abstract

Purpose of Review

Ureteral stent placement is a very common urologic procedure and a necessary component of many minimally invasive surgeries including ureteroscopy. Despite its widespread use, stent placement results in bothersome urinary symptoms and pain in approximately 80% of patients. This review discusses the proposed mechanisms underlying ureteral stent-related symptoms and current approaches to symptom management and the evidence to support them.

Recent Findings

Though it has been extensively studied, the exact cause of stent-related symptoms remains unknown but is likely related to irritation of the bladder by the distal curl of the stent and reflux of urine through the stent up to the renal pelvis and transmission of high pressures associated with this. Recent research has focused on trying to modify stents including the creation of drug eluting stents as well as preventing symptoms with intravesical instillation of medications in the operative room at the time of placement. Some of these approaches show promise, but anticholinergic and alpha-blocking medications remain the only treatments for stent-related symptoms with reasonable evidence to support them.

Summary

Current evidence suggests that a multimodal approach to stent-related symptoms and pain with alpha-blockers, anticholinergic medications, and anti-inflammatory and narcotic pain medications is likely the most effective. Further research is needed to better investigate many novel techniques for decreasing stent-related symptoms. This continues to be an important area of research given the need for ureteral stents in urology and the high prevalence of patient discomfort related to stent placement.

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Author information

Authors and Affiliations

  1. Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, USA

    Katherine M. Fischer & Phillip Mucksavage

  2. Department of Urology, University of California Irvine Health, Irvine, USA

    Michael Louie

Authors
  1. Katherine M. Fischer
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  2. Michael Louie
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Correspondence to Phillip Mucksavage.

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Katherine M. Fischer and Michael Louie each declare no potential conflicts of interest.

Phillip Mucksavage is a section editor for Current Urology Reports.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Endourology

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Fischer, K.M., Louie, M. & Mucksavage, P. Ureteral Stent Discomfort and Its Management. Curr Urol Rep 19, 64 (2018). https://doi.org/10.1007/s11934-018-0818-8

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