Category: Clinical Stones: Equipment (stents, lasers, guidewires, sheaths)

MP27-11 - Does the degree of hydroureteronephrosis impact stent related pain?

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective : Few studies have shown that a stent inserted in situ after ureteroscopic stone removal will cause some discomfort in spite of medications and will persist till the stent is removed. Also it has been observed that a misplaced stent causes more discomfort than a stent which is in
correct position. Ureteric stones inevitably cause some degree of hydroureteronephrosis. This has been classified into broadly two categories by the radiologist namely mild and the second group encompasses moderate to severe hydroureteronephrosis. Usually, patients presenting in acute stages have mild hydroureteronephrosis where as patients presenting with slightly longer duration have more dilatation. As of date, there has been no study which has studied the impact of this hydroureteronephrosis on stent related discomfort. We feel that patients presenting with moderate hydroureteronephrosis will have greater accomodative property and hence tolerate the stent better. Present study is an endeavor towards getting an answer for the same.


Methods : A total of 80 patients who underwent ureteroscopic removal for stone disease were included in the study. These patients were divided into
two groups of forty each. The two groups were identical in all baseline characteristics and differed only in the degree of hydroureteronephrosis. Pain was analyzed by the Visual analogue score (VAS).


Results : Mann-Whitney  U test was used to compare post double j stenting pain in patients presenting with mild hydroureteronephrosis against
patients presenting with moderate hydroureteronephrosis. From Table 1, we observe that the p value is difference between post double j stenting pain in patients presenting with mild hydroureteronephrosis when compared to patients presenting with moderate
hydroureteronephrosis. Pain level in post double j stenting patients presenting with mild hydroureteronephrosis is significantly higher when compared to patients presenting with moderate hydroureteronephrosis


Conclusions : Patients presenting with moderate hydroureteronephrosis tolerate the double J stent better than patients with mild hydroureteronephrosis probably due to the greater accomodative property of the dilated ureter. Drugs to relieve pain like anticholinergics or alpha blockers can be
given in lesser doses in this group.

Maniyur Raghavendran

Chief consultant urologist and transplant surgeon
Apollo BGS Hospitals, ,Mysuru
Mysore, Karnataka, India

Kiran G Kumar

consultant urologist and transplant surgeon
Apollo BGS Hospitals, ,Mysuru
Mysore, Karnataka, India

Keyur Patel

Registrar
Apollo BGS Hospitals, ,Mysuru
Mysore, Karnataka, India