Impact of Ureteral Stent Material on Stent-related Symptoms: A Systematic Review of the Literature

Matthias Boeykens; Etienne X Keller; Andrea Bosio; Oliver J Wiseman; Pablo Contreras; Eugenio Ventimiglia; Michele Talso; Amelia Pietropaolo; Thomas Tailly; Vincent De Coninck

doi:10.1016/j.euros.2022.09.005

Impact of Ureteral Stent Material on Stent-related Symptoms: A Systematic Review of the Literature

Eur Urol Open Sci. 2022 Oct 19:45:108-117. doi: 10.1016/j.euros.2022.09.005. eCollection 2022 Nov.

Authors

Matthias Boeykens¹, Etienne X Keller^{2

3

4}, Andrea Bosio⁵, Oliver J Wiseman⁶, Pablo Contreras⁷, Eugenio Ventimiglia^{3

4

8}, Michele Talso^{3

9}, Amelia Pietropaolo^{3

10}, Thomas Tailly^{3

11}, Vincent De Coninck^{3

4

12}

Affiliations

¹ Department of Urology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
² Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
³ Young Academic Urologists Urolithiasis and Endourology Working Group, European Association of Urology, Arnhem, The Netherlands.
⁴ Progressive Endourological Association for Research and Leading Solutions, Paris, France.
⁵ Department of Urology, Città della Salute e della Scienza, Molinette University Hospital, Turin, Italy.
⁶ Urology Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
⁷ Servicio de Urología, Hospital Alemán, Buenos Aires, Argentina.
⁸ Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
⁹ Department of Urology, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.
¹⁰ Department of Urology, University Hospital Southampton, Southampton, UK.
¹¹ Academic Department of Urology, University Hospital Ghent, University of Ghent, Ghent, Belgium.
¹² Department of Urology, AZ Klina, Brasschaat, Belgium.

Abstract

Context: Ureteral stents are essential implants that are used on a daily basis. Since their invention, advances in stent design have been directed towards alleviating stent-related symptoms. It remains unclear how the material composition of the stent affects stent-related symptoms.

Objective: To review the literature and define the clinical impact of ureteral stent material on stent-related symptoms.

Evidence acquisition: A literature search of the Embase, MEDLINE (PubMed), and Web of Science databases was conducted on December 17, 2021 to collect articles comparing stent composition materials regarding stent-related symptoms. Thirteen publications met the inclusion criteria, of which only one met the high-quality requirements of the Cochrane Collaboration tool for assessing the risk of bias in randomized trials.

Evidence synthesis: Most trials, including the highest quality trial, seem to support that silicone double-J (DJ) stents reduce stent-related symptoms compared to nonsilicone DJ stents. Regarding physical properties, it seems that "soft" or "flexible" DJ stents reduce stent-related symptoms. However, since there was only one high-quality study with a low risk of bias, it is impossible to draw a definitive conclusion owing to the lack of quality data.

Conclusions: Silicone DJ stents, and by extension "soft" DJ stents, appear to reduce stent-related symptoms compared to nonsilicone polymers and "hard" DJ stents. No definitive conclusion can be drawn owing to a lack of quality evidence. Creating a standard for measuring and reporting physical stent properties should be the first step for further research.

Patient summary: A ureteral stent is a small hollow tube placed inside the ureter to help urine drain from the kidney. We reviewed the literature on the impact of stent material on stent-related symptoms. We found that silicone may reduce stent-related symptoms, but no definitive conclusion can be drawn and further studies are needed.

Keywords: Double-J stent; Material; Review; Stent-related discomfort; Stent-related symptoms; Ureteral stent; Urolithiasis.

Publication types

Review