Comparison of the effects of commonly used double-J stents on stone-free rates and ureteral stent-related symptoms after lithotripsy for upper urinary tract stones

Introduction: Evidence on the impact of different stent sizes on stone-free rate (SFR) and ureteral stent-related symptom questionnaire (USSQ) scores in endoscopic lithotripsy remains limited. This study aimed to evaluate the effects of 2 commonly used double-J stents of different diameters on these outcomes. Material and methods: We retrospectively reviewed 108 patients with upper urinary tract stones who underwent lithotripsy between January 2022 and December 2023. Patients were stratified into 4.7F and 6F groups based on stent diameter. Primary outcomes were SFR at 24 h and 30 days. USSQ scores and complications were compared between groups. Results: SFR was similar between groups at 24 h (52.5% vs 55.1%; p = 0.791) and 30 days (74.6% vs 77.6%; p = 0.719). USSQ scores were comparable (Urinary Symptoms: 29 vs 29, p = 0.473; Body Pain: 12 vs 12.5, p = 0.347; General Health: 13 vs 13, p = 0.706; Work Performance: 8 vs 8, p = 0.072; Sexual Matters: 4 vs 3, p = 0.242; Additional Problems: 12 vs 12, p = 0.485). More patients in the 4.7F group reported hematuria (83.1% vs 69.4%; p = 0.094) and changes in daily work activities. Many experienced body pain (76.9%) and absence of sexual activity (88.9%). No complications exceeded grade II. Conclusions: Both 4.7F and 6F stents showed similar efficacy and safety. Stent size did not significantly impact USSQ scores or SFR.