Authors (including presenting author) :
W L To, S F Chu, H Y Chan, L K Yung
Affiliation :
Division of Urology, Department of Surgery, Princess Margaret Hospital, Hong Kong
Keyword 1: :
Magnetic ureteric stent
Keyword 3: :
Cost-effectiveness
Keyword 4: :
Ureteric stent symptoms
Introduction :
Ureteric stents are double-J catheters placed within the ureter to maintain luminal patency, facilitate urinary drainage from the renal pelvis to the bladder, and treat or prevent obstruction. Ureteric stents are associated with patient discomfort, urinary symptoms, and the need for cystoscopic removal, which increases healthcare costs and resource utilization. Magnetic ureteric stents, incorporating a distal magnetic bead for non endoscopic removal, offer a minimally invasive alternative that can be removed by a retriever in the nurse clinic setting.
Objectives :
This study aimed to evaluate the cost effectiveness and patient outcomes of magnetic ureteric stents compared with regular stents, using the Ureteral Stent Discomfort Test (USDT) and Visual Analogue Scale (VAS) pain scores.
Methodology :
A prospective evaluation was conducted in patients receiving either magnetic or conventional ureteric stents. 12 patients with magnetic stents and 12 patients with conventional stents were recruited and completed the Ureteric Stent Discomfort Test (USDT) and Visual Analogue Scale (VAS) pain score on the day of stent removal. UDST is a questionnaire to evaluate the severity and impact of ureteric stent related symptoms on quality of life which assessed across six domains: urinary symptoms (Q1–6), pain (Q7–8), daily life (Q9), sexual life (Q10), medical care and analgesic use (Q11–12), and overall quality of life (Q13). VAS was used to evaluate the discomfort induced by ureteric stent removal procedure either by flexible cystoscopy in convention stent group or by retriever in magnetic stent group.
Result & Outcome :
Magnetic stents group only demonstrated significantly difference over urinary symptom domain compared with conventional stents group (7.05 vs 9.9, p = 0.031). There were no significant different in other domains of pain, daily life, medical care and analgesic use, and overall stent symptom burden. VAS pain scores were also reduced (3.7 vs 5.1, p = 0.041), supporting improved tolerance in removal magnetic with retriever over cystoscopy. Cost effectiveness analysis highlighted reduced need for cystoscopic removal, fewer medical visits, translating into measurable healthcare savings. Magnetic ureteric stents are a clinically effective and economically favorable alternative to conventional stents. Although they did not show a significant difference in the overall stent symptom burden, they demonstrated a significant difference in the urinary symptoms, while maintaining comparable outcomes in other domains. They significantly reduced pain scores associated with stent removal.
Their ease of removal in nurse led clinics reduce the need of cystoscopy and reserves valuable cystoscopy capacity for patients who in need, hence optimize healthcare resource utilization. Overall, magnetic ureteric stents align clinical efficacy with patient centered care and cost effectiveness.
