Factors That Increase the Risk of Ureteric Stent Migration: A Retrospective Cohort Analysis

Abstract

Abstract Background/Objectives: Ureteric stents are commonly used in urological procedures. However, they can cause pain; haematuria; voiding symptoms; or stent migration. When stent migration occurs, this can cause a significant impact on the patients’ therapeutic outcomes and may warrant a repeat procedure to retrieve or replace the ureteric stent. This study aims to assess if there are any patient; stent; or operative factors that may increase the risk of stent migration. Methods: This is a single-institute, retrospective cohort study that looked at patient; stent; and operative factors for 828 ureteroscopies and or laser lithotripsy for management of ureteric or intra-renal calculi over a 2-year period. The 828 procedures comprised 655 patients, as some patients had multiple procedures. Results: From the 828 cases, there was a 2.7% incidence of stent migration; all episodes of stent migration were distal migration. Stent migration was more likely among females (odds ratio (OR) = 3.0; 95% confidence interval (CI) [1.2; 7.1]) compared to males; older aged groups (over 65 years) (OR = 2.7; 95% CI [0.9; 7.8]) compared to the young aged group (16–44 years); and those who were obese (OR = 2.1; 95% CI [0.9; 5.0]), had musculocutaneous (MSK) conditions (OR = 2.7; 95% CI[0.9; 8.3]), neurological conditions (OR = 3.3; 95% CI [1.1; 10.0]), and stent dwelling time ≥ month (OR =2.3; 95% CI [0.9; 6.0]) compared to <1 month. There was no observed association between stent and operative factors. Conclusions: Patient factors such as sex; age; comorbidities; and weight need to be considered by urologists in conjunction with modifiable stent factors to ensure that the decisions are made on an individual basis to try and reduce the risk of stent migration.