Comparison of Patient Acceptance of Polyurethane vs. Silicone Indwelling Ureteral Stents

Abstract

The symptomatic effects and positional stability of four types of ureteral stents—double-pigtail polyurethane, double figure-four silicone, double-pigtail silicone, and double-J blended polyurethane—were compared in 66 patients. The most common complaint was urinary frequency (more than once every 3 hours), which occurred in 18 of the 20 patients with double-pigtail polyurethane stents, 16 of 19 with double figure-four silicone stents, 13 of 17 with double-pigtail silicone stents, and 6 of 8 with double-J blended polyurethane stents. Nocturia was somewhat less common (13,12,4, and 3, respectively). Urgency (17,14, 9, and 3) and occasional urge incontinence (3, 2, 0, and 0) were reported. Approximately half of the patients with the polyurethane stents vs. one fourth to one third of those with silicone stents had dysuria. There was no significant correlation between the length of stent in the bladder and the symptoms, although the stents with the shortest intravesical portions were associated with the fewest irritative symptoms and the stent with the largest renal pelvic segment (double figure four) carried the highest incidence of flank discomfort. Stent migration was dependent on tip configuration, with pigtail and figure-four stents remaining in place and double-J stents tending to migrate either proximally or distally. The authors prefer to use silicone double-pigtail stents and note that patients should be told to expect irritative symptoms.