Charles D Scales1, H Henry Lai2,3, Alana C Desai2, Jodi A Antonelli4, Naim M Maalouf5, Gregory E Tasian6,7, Peter P Reese7,8, Michele Curatolo9, Kevin Weinfurt10, Hussein R Al-Khalidi11, Hunter Wessells12, Ziya Kirkali13, Jonathan D Harper12. 1. Departments of Surgery and Population Health Sciences, Duke Surgical Center for Outcomes Research, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA. 2. Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA. 3. Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA. 4. Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. 5. Department of Internal Medicine and Charles, Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA. 6. Department of Surgery, Division of Pediatric Urology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. 7. Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 8. Renal-Electrolyte and Hypertension Division, Department of Medicine, The Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 9. Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, USA. 10. Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA. 11. Department of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA. 12. Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA. 13. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA.
Abstract
Background: Ureteral stents are commonly employed after ureteroscopy to treat urinary stone disease, but the devices impose a substantial burden of stent-associated symptoms (SAS), including pain and urinary side effects. The NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases) Urinary Stone Disease Research Network sought to develop greater understanding of SAS causes and severity among individuals treated ureteroscopically for ureteral or renal stones. Materials and Methods: We designed a prospective, observational cohort study comprising adolescents and adults undergoing ureteroscopic intervention for ureteral or renal stones. Participants will undergo detailed symptom assessment using validated questionnaires, a psychosocial assessment, and detailed collection of clinical and operative data. Quantitative sensory testing will be utilized to assess pain sensitization. In addition, a small cohort (∼40 individuals) will participate in semi-structured interviews to develop more granular information regarding their stent symptoms and experience. Biospecimens (blood and urine) will be collected for future research. Results: The Study to Enhance Understanding of sTent-associated Symptoms (STENTS) enrolled its first participant in March 2019 and completed nested qualitative cohort follow-up in August 2019. After a planned pause, enrollment for the main study cohort resumed in September 2019 and is expected to be completed in 2021. Conclusion: STENTS is expected to provide important insights into the mechanisms and risk factors for severe ureteral SAS after ureteroscopy. These insights will generate future investigations to mitigate the burden of SAS among individuals with urinary stone disease.
Background: Ureteral stents are commonly employed after ureteroscopy to treat urinary stone disease, but the devices impose a substantial burden of stent-associated symptoms (SAS), including pain and urinary side effects. The NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases) Urinary Stone Disease Research Network sought to develop greater understanding of SAS causes and severity among individuals treated ureteroscopically for ureteral or renal stones. Materials and Methods: We designed a prospective, observational cohort study comprising adolescents and adults undergoing ureteroscopic intervention for ureteral or renal stones. Participants will undergo detailed symptom assessment using validated questionnaires, a psychosocial assessment, and detailed collection of clinical and operative data. Quantitative sensory testing will be utilized to assess pain sensitization. In addition, a small cohort (∼40 individuals) will participate in semi-structured interviews to develop more granular information regarding their stent symptoms and experience. Biospecimens (blood and urine) will be collected for future research. Results: The Study to Enhance Understanding of sTent-associated Symptoms (STENTS) enrolled its first participant in March 2019 and completed nested qualitative cohort follow-up in August 2019. After a planned pause, enrollment for the main study cohort resumed in September 2019 and is expected to be completed in 2021. Conclusion: STENTS is expected to provide important insights into the mechanisms and risk factors for severe ureteral SAS after ureteroscopy. These insights will generate future investigations to mitigate the burden of SAS among individuals with urinary stone disease.
Entities:
Keywords:
stent-associated symptoms; ureteral stents; ureteroscopy; urinary stone disease
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