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Corneli A, Dombeck C, McKenna K, Harper JD, Antonelli JA, Desai AC, Lai HH, Tasian GE, Ziemba J, McCune R, Piskator B, Al-Khalidi HR, Maalouf NM, Reese PP, Wessells H, Kirkali Z, Scales CD. The Patient Voice: Stent Experiences After Ureteroscopy-Insights from In-Depth Interviews with Participants in the USDRN STENTS Nested Qualitative Cohort Study. J Endourol 2023; 37:642-653. [PMID: 37021358 PMCID: PMC10280172 DOI: 10.1089/end.2022.0810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Purpose: Ureteral stents are commonly used after ureteroscopy and cause significant discomfort, yet qualitative perspectives on patients' stent experiences remain unknown. We describe psychological, functional, and interpersonal effects of post-ureteroscopy stents and whether additional patient-reported assessments may be needed. Materials and Methods: Using a qualitative descriptive study design, we conducted in-depth interviews with a nested cohort of participants in the STudy to Enhance uNderstanding of sTent-associated Symptoms (STENTS). Participants shared their symptoms with a post-ureteroscopy stent and described symptom bother and impact on daily activities. All interviews were audio-recorded, transcribed, and analyzed using applied thematic analysis. During analysis, participants' experiences with interference in daily activities were categorized into three groups based on their impact: minimal, moderate, and substantial. Results: All 39 participants experienced pain, although descriptions varied and differentiated between feelings of pain vs discomfort. Almost all experienced urinary symptoms. Only a few reported other physical symptoms, although several psychological aspects were identified. In the areas of sleep, mood, life enjoyment, work, exercise, activities of daily living, driving, childcare, and leisure/social activities, the stent had little impact on daily living among participants placed in the minimal group (n = 12) and far greater impact for participants in the substantial group (n = 8). For patients in the moderate group (n = 19), some daily activities were moderately or substantially affected, whereas other activities were minimally affected. Conclusions: Counseling to better prepare patients for the impact of stent-associated symptoms may help mitigate symptom burden. While existing instruments adequately cover most symptoms, additional assessments for other domains, particularly psychological factors, may be needed.
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Affiliation(s)
- Amy Corneli
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Carrie Dombeck
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kevin McKenna
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jonathan D. Harper
- Department of Urology, University of Washington, Seattle, Washington, USA
| | - Jodi A. Antonelli
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Alana C. Desai
- Department of Surgery (Urologic Surgery) and Washington University in St. Louis, St. Louis, Missouri, USA
| | - H. Henry Lai
- Department of Surgery (Urologic Surgery) and Washington University in St. Louis, St. Louis, Missouri, USA
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Gregory E. Tasian
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Justin Ziemba
- Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rebecca McCune
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Brooke Piskator
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hussein R. Al-Khalidi
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Naim M. Maalouf
- Department of Internal Medicine and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Peter P. Reese
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hunter Wessells
- Department of Urology, University of Washington, Seattle, Washington, USA
| | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Charles D. Scales
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Surgery (Urology), Duke Surgical Center for Outcomes Research and Equity in Surgery, Duke University School of Medicine, Durham, North Carolina, USA
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