To describe the experiences of patients undergoing stent removal in the USDRN Study to Enhance Understanding of Stent-Associated Symptoms (STENTS), a prospective, observational cohort study of patients with short-term ureteral stent placement post-ureteroscopy.
We conducted a qualitative descriptive study using in-depth interviews. Participants reflected on (1) painful or bothersome aspects of stent removal, (2) symptoms immediately after removal, and (3) symptoms in the days following removal. Interviews were audio-recorded, transcribed, and analyzed using applied thematic analysis.
The 38 participants interviewed were aged 13 to 77 years, 55% female, and 95% White. Interviews were conducted 7-30 days after stent removal. Almost all participants (n=31) described that they experienced either pain or discomfort during stent removal, but for most (n=25) pain was of short duration. Many participants (n=21) described anticipatory anxiety related to the procedure, and several (n=11) discussed discomfort arising from lack of privacy or feeling exposed. Interactions with medical providers often helped put participants at ease, but also increased discomfort for some. Following stent removal, several participants described lingering pain and/or urinary symptoms, but these largely resolved within 24 hours. A few participants described symptoms persisting for more than a day post stent removal.
These findings on patients' experiences during and shortly after ureteral stent removal, particularly the psychological distress they experienced, identify opportunities for improvement in patient care. Clear communication from providers about what to expect with the removal procedure, and the possibility of delayed pain, may help patients adapt to discomfort.
Urology. 2023 May 04 [Epub ahead of print]
Carrie Dombeck, Charles D Scales, Kevin McKenna, Teresa Swezey, Jonathan D Harper, Jodi A Antonelli, Alana C Desai, H Henry Lai, Rebecca McCune, Michele Curatolo, Hussein R Al-Khalidi, Naim M Maalouf, Peter P Reese, Hunter Wessells, Ziya Kirkali, Amy Corneli, NIDDK Urinary Stone Disease Research Network
Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina., Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina; Department of Surgery (Urology), Duke Surgical Center for Outcomes Research & Equity in Surgery, Duke University School of Medicine, Durham, North Carolina. Electronic address: ., Department of Urology, University of Washington, Seattle, Washington., Department of Surgery (Urology), Duke Surgical Center for Outcomes Research & Equity in Surgery, Duke University School of Medicine, Durham, North Carolina., Department of Surgery (Urologic Surgery), Washington University in St. Louis, St. Louis, Missouri., Department of Surgery (Urologic Surgery), Washington University in St. Louis, St. Louis, Missouri; Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri., Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington., Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina., Department of Internal Medicine and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas., Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland., Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.