Comparative Study of Ureteral Stent Diameters on Stent - Related Symptoms

Abstract

Background: Ureteral double-J (DJ) stents are routinely used following endourological procedures to maintain ureteral patency. However,
stent-related symptoms (SRSs), including pain, lower urinary tract symptoms, impaired quality of life, and sexual dysfunction, remain common.
Stent diameter is a potentially modifiable factor that may influence symptom severity.
Objective: To compare the effect of 4.5 Fr and 6 Fr ureteral stents on stent-related symptoms using the Ureteral Stent Symptom Questionnaire
(USSQ).
Materials and Methods: A hospital-based observational study was conducted over 18 months at Muzaffarnagar Medical College and Hospital.
Fifty adult patients undergoing double-J stent placement following endourological procedures were enrolled and allocated into two groups
according to stent diameter: Group A (4.5 Fr, n=25) and Group B (6 Fr, n=25). All patients received standardized 24-cm stents from the same
manufacturer, which were removed after 4–6 weeks. At stent removal, patients completed the validated USSQ. Primary outcomes included Pain
Index Score (PIS), Urinary Index Score (UIS), General Health Index Score (GHIS), Sexual Symptom Score, and work-loss days. Data were
analyzed using Student’s t-test, with p<0.05 considered statistically significant.
Results: Baseline demographic characteristics were comparable between the groups. Patients receiving 4.5 Fr stents demonstrated significantly
lower symptom scores than those receiving 6 Fr stents: PIS (15.2±3.1 vs. 19.6±4.2; p<0.01), UIS (20.8±4.5 vs. 25.4±5.2; p=0.02), GHIS
(13.4±3.8 vs. 16.2±4.1; p=0.04), Sexual Symptom Score (4.1±1.2 vs. 6.3±1.8; p<0.01), and work-loss days (2.4±1.1 vs. 4.1±1.7; p<0.01).
Conclusion: Smaller-caliber 4.5 Fr ureteral stents were associated with significantly reduced stent-related morbidity and improved quality of life
compared with 6 Fr stents, without compromising clinical effectiveness. When clinically feasible, smaller-diameter stents should be considered
to enhance postoperative patient comfort and functional recovery.