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The following is a summary of “Reverse placement of a double J ureteral stent improves lower urinary tract symptoms,” published in the February 2025 issue of BMC Urology by Bayar et al.
Researchers conducted a retrospective study on the clinical efficacy and patient-reported discomfort of traditional vs reverse double-J ureteral stent (DJUS) placement in ureteroscopic stone removal.
They conducted a prospective, randomized, single-center, one-blinded, controlled study. They placed the double-J stent in the control group, with the upper end facing laterally and the lower end medially, while the study group had the reverse placement. They further subdivided the study group into B1 (upper medial/lower lateral), B2 (both medial), and B3 (both lateral). They assessed patient discomfort using the Turkish Ureteral Stent Symptom Questionnaire (T-USSQ) and evaluated postprocedural hydronephrosis, hematuria, and urinary tract infection.
The results showed that 120 patients were included, with 60 in each group. Group B had lower USSQ scores (P < 0.05) and reduced analgesic use. Midline crossing was less frequent in Group B (11.7% vs. 30%; P = 0.013). Subgroup analysis showed B1 (40 patients) and B3 (12 patients) had lower analgesic use and symptom scores, while B2 (8 patients) had higher hydronephrosis and symptom scores.
Investigators found that reverse DJUS placement with both ends laterally positioned reduced discomfort and suggested a new stent design, “ipsi-DJUS.”
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01705-x
