Open Access

ARTICLE

Stent duration and increased pain in the hours after ureteral stent removal

Michael E. Rezaee¹, Annah J. Vollstedt¹, Tammer Yamany², Manoj Monga^3,4, Amy Krambeck^4,5, Ojas Shah^4,6, Roger L. Sur^3,4, Anna M. Zampini^4,7, Kymora B. Scotland^4,8, Ben H. Chew^4,8, Brian H. Eisner^2,4, Vernon M. Pais Jr^1,4

1 Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
2 Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
3 Department of Urology, UC San Diego Health, San Diego, California, USA
4 Endourology Disease Group of Excellence
5 Indiana University Health Physicians Urology, Indianapolis, Indiana, USA
6 Columbia University Irving Medical Center, New York, New York, USA
7 Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, Ohio, USA
8 The University of British Columbia, Vancouver, British Columbia, Canada
Address correspondence to Dr. Vernon M. Pais Jr, Section of Urology, Department of Surgery, Dartmouth Hitchcock Medical Center, 5 Medical Center Drive, Lebanon, NH, 03756 USA

Canadian Journal of Urology 2021, 28(1), 10516-10521.

Abstract

Introduction: To assess the relationship between pain after ureteral stent removal and patient and procedural factors.
Materials and methods: A validated survey designed to assess the relationship between quality of life and treatment decisions in kidney stone disease was randomly distributed to patients with a history of a ureteral stent in seven medical centers across North America participating in an endourology research collaborative between July 2016 and June 2018. The primary outcome was increased pain after ureteral stent removal. Statistical analyses were performed using Chi-square and multiple logistic regression.
Results: A total of 327 surveys were analyzed. Twenty seven percent of patients reported increased pain in the hours after ureteral stent removal. Patients with a stent ≤ 7 days were significantly more likely to experience pain after stent removal compared to those with a stent > 7 days (33.3% versus 22.8%, p = 0.04). Female gender (OR: 2.41, 95% CI: 1.42-4.10) was associated with increased pain after stent removal, while increasing age was inversely associated (OR: 0.52, 95% CI: 0.36-0.74). After adjustment, patients with a stent > 7 days were significantly less likely to report pain in the hours after removal (OR: 0.59, 95% CI: 0.35-0.99).
Conclusions: Approximately one in four patients will experience increased pain after ureteral stent removal. Female patients, younger patients, and patients with a stent ≤ 7 days were more likely to experience an increase in pain immediately following stent removal. Understanding factors associated with post-stent removal pain may be helpful in counseling patients at high risk stent removal morbidity.

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