Self-retaining ureteral stents: Analysis of factors responsible for patients' discomfort
Self-retaining ureteral stents: Analysis of factors responsible for patients' discomfort
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DOI：
10.1089/end.2006.20.33
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发表时间：
2006-01-01
影响因子：
2.7
通讯作者：
El-Kappany, HA
中科院分区：
文献类型：
--
作者：
El-Nahas, AR;El-Assmy, AM;El-Kappany, HA
目的：确定自保留输尿管支架植入期间影响患者不适的因素。患者和方法：2001年4月至2003年5月期间，58名男性和42名女性患者接受了临时双猪尾支架植入术。39例患者的适应症为肾盂内切开术，32例为输尿管镜检查术，18例为腹腔镜肾盂成形术，11例为输尿管内切开术。56例患者的支架为硅胶支架，44例患者的支架为Percuflex支架。中位支架植入期为8周（范围4-16周）。在支架取出前，通过医生进行的问卷调查评价患者不适。试验变量为患者性别、支架侧面、尿培养、支架材料、支架长度和直径以及支架植入时间。还测试了上部线圈的位置（肾盂或肾盏）、下部线圈的位置（在同侧或穿过中线）以及下部线圈的形状（完整圆形或非完整圆形）。结果：59例患者出现排尿困难、尿急、急迫性尿失禁、腰部疼痛、耻骨上疼痛、尿频、尿痛、肉眼血尿或两者兼有的不适症状。与不适相关的显著因素为尿培养阳性、支架下端与对侧交叉、上弹簧圈位于肾盏位置及较长的支架置入时间。结论：正确放置支架弹簧圈、根除感染及缩短支架置入时间可减少患者在输尿管支架置入期间的不适。
Purpose: To determine factors affecting patients' discomfort during the period self-retaining ureteral stents are in place.Patients and Methods: Between April 2001 and May 2003, 58 male and 42 female patients underwent temporary double-pigtail stenting. The indications were endopyelotomy in 39 patients, ureteroscopy in 32, laparoscopic pyeloplasty in 18, and endoureterotomy in 11. The stents were silicone in 56 patients and Percuflex in 44. The median stenting period was 8 weeks (range 4-16 weeks). Patient discomfort was evaluated by a questionnaire conducted by the physician before stent removal. Tested variables were patients' sex, side of the stent, urine culture, stent material, stent length and diameter, and stenting duration. The site of the upper coil (renal pelvis or calix), the site of the lower coil (in the same side or crossing the midline), and the shape of the lower coil (complete circle or not) were also tested. Univariate and multivariate analysis were carried out to determine significant independent variables, with P < 0.05 being significant.Results: Of the total, 59 patients experienced discomfort consisting of dysuria, urgency, urge incontinence, loin pain, suprapubic pain, frequency, nocturia, or gross hematuria or some combination. Significant factors associated with discomfort were a positive urine culture, crossing of the lower end of the stent to the opposite side, caliceal position of the upper coil, and longer stenting duration.Conclusion: Proper positioning of the coils of the stent, eradication of infection, and shorter stenting duration are advised to decrease patient discomfort during the period of ureteral stenting.