Novel Stanley Stent Symptom Status Score (s5 score) for predicting ureteral stent-related symptoms

Abstract

Background : It is a known fact that endourological procedures frequently require placement of double J (DJ) ureteral stent. These patients can have stent-related symptoms (SRS) after DJ stent placement which can be distressing with increased morbidity. Though intraoperative and postoperative factors for SRS have been studied, research work is deficient in preoperative prediction of these symptoms which is the need of the hour. Thus, we aim to find out the factors which can lead to SRS after ureteroscopic lithotripsy (URSL) surgeries. Further, we aim to establish a scoring system which will help us predict the possibility of SRS and take necessary actions to minimise them. Materials and methods: Our study includes 150 URSL cases with DJ stenting where we correlated various factors with the presence of SRS. Information regarding preoperative, intraoperative and postoperative factors which may lead to SRS were noted down. All patients completed Ureteral Stent Symptom Questionnaire (USSQ) to evaluate the symptoms at 1 and 3 weeks after stent placement and 1 week after removal of the stent. The statistical data were evaluated using SPSS 24 Statistics. Results: In our study, we found that SRS correlated statistically with factors namely body mass index (BMI) > 25 kg/m2, loin pain, stone size > 1 cm, haematuria, bilateral stone disease, incomplete distal curl, distal end crossing midline and these could predict the occurrence of SRS. Based on the significant preoperative factors, we constructed the Stanley Stent Symptom Status Score (S5 Score) which predicts the possibility of developing SRS. Conclusion: Thorough understanding of factors which can lead to SRS can help us take steps to reduce the morbidity related with this frequent procedure. Stanley Stent Symptom Status Score (S5 Score) predicts the occurrence of these symptoms preoperatively. This score is first of its kind which will pave the way for deeper understanding and prediction of these symptoms preoperatively.