Age, depression linked to pain intensity following ureteroscopy for urinary stones

In patients undergoing ureteroscopy for urinary stones, pain intensity lessened but interference appears to persist, reports a study. Symptom intensity is associated with several patient factors, such as age and depression, rather than surgical factors.

A group of researchers conducted this prospective observational cohort study in patients aged ≥12 years who underwent ureteroscopy with ureteral stent for stone treatment at four clinical centres. Participants reported symptoms at baseline; on postoperative days 1, 3, and 5; at stent removal; and day 30 following stent removal.

Multiple instruments were used to measure the outcomes of pain intensity, pain interference, urinary symptoms, and bother. Finally, the research team performed multivariable analyses using mixed-effects linear regression models to identify characteristics associated with increased stent-related symptoms.

Some 424 patients (mean age 49 years, 47 percent female) were included in the study. These patients showed a significant increase in stent-associated symptoms on postoperative day 1. Pain intensity decreased by about 50 percent from postoperative day 1 to day 5, but interference due to pain remained “persistently elevated.”

Multivariable analyses revealed the association of old age with lower pain intensity (p=0.004), while having chronic pain conditions (p<0.001), prior severe stent pain (p=0.021), and depressive symptoms at baseline (p<0.001) each correlated with higher pain intensity. On the other hand, sex, stone location, ureteral access sheath use, and stent characteristics were not associated with stent-related symptoms.

“These findings provide a foundation for patient-centred care and highlight potential targets for efforts to mitigate the burden of stent-associated symptoms,” the researchers said.