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Notion Database > Stent-Associated Symptoms Following URS: Risk Factors and Patient Outcomes > Flashcards

Stent-Associated Symptoms Following URS: Risk Factors and Patient Outcomes Flashcards

1
Q

Question 1
Which of the following patient characteristics were associated with having significantly higher pain intensity:

Choose one

Baseline depression

Stone location and sheath use

Older age

Ureteroscopy time

A
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2
Q

Q: What happens to pain intensity and interference following stent placement after URS?

A

Pain intensity spikes on POD 1 and decreases by 50% by POD 5, but pain interference remains elevated longer.

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3
Q

Which patient factors are linked to higher pain intensity following URS and stent placement?

A

A: Chronic pain conditions, prior severe stent pain, and depression are associated with higher pain intensity.

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4
Q

Q: Were stone location, UAS use, or stent characteristics associated with increased stent symptoms?

A

A: No, these surgical and stone factors were not significant contributors to stent-associated symptoms.

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5
Q

Q: What effect does age have on stent-associated pain after URS?

A

A: Older age is associated with lower pain intensity, though pain interference may still persist.

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6
Q

Q: What percentage reduction in pain intensity is typically seen by POD 5?

A

A: A 50% reduction from POD 1 levels.

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7
Q
  1. Card 1: Post-URS Symptom Peak
    • Q: When do stent-associated symptoms peak after URS?
A

A: Postoperative Day 1 (POD 1).

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8
Q
  1. Card 2: Pain Intensity Reduction by POD 5
    • Q: By how much does pain intensity typically decrease by POD 5 after URS and stent placement?
A

A: 50% reduction from POD 1.

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9
Q
  1. Card 3: Pain Interference Beyond POD 5
    • Q: How does pain interference evolve beyond POD 5 after stent placement?
A

A: It remains elevated even as pain intensity decreases.

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10
Q
  1. Card 4: Urinary Symptom Trends
    • Q: What happens to urinary symptoms after POD 5 following stent placement?
A

A: They decrease but remain elevated until stent removal.

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11
Q
  1. Card 5: Impact of Older Age on Pain Intensity
    • Q: How does older age affect pain intensity following URS and stent placement?
A

A: Older age is associated with lower pain intensity.

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12
Q
  1. Card 6: Chronic Pain and Stent Pain History
    • Q: Which two patient factors are linked to higher pain intensity after URS and stent placement?
A

A: Chronic pain conditions and prior severe stent pain.

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13
Q
  1. Card 7: Depression and Pain Intensity
    • Q: How does baseline depression affect stent-associated symptoms?
A

A: Depression is associated with higher pain intensity.

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14
Q
  1. Card 8: Effect of BMI on Urinary Symptoms
    • Q: Which factor is linked to urinary bother following stent placement after URS?
A

A: Higher BMI.

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15
Q
  1. Card 9: Predictors of Higher Urinary Bother
    • Q: What two factors contribute to increased urinary bother following URS and stent placement?
A

A: BMI and baseline depression.

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16
Q
  1. Card 11: Sex Differences in Stent Symptoms
    • Q: Was there a significant difference in stent-associated symptoms based on sex?
A

A: No, sex did not influence stent-associated symptoms.

17
Q
  1. Card 10: UAS Use and Stent-Associated Symptoms
    • Q: Did ureteral access sheath (UAS) use correlate with increased stent-associated symptoms?
A

A: No, UAS use did not significantly affect symptom intensity.

18
Q
  1. Card 12: Surgical and Stone Factors
    • Q: Were stone location or stent characteristics associated with increased symptoms after URS?
A

A: No, surgical and stone factors did not play a significant role.

19
Q
  1. Card 13: Importance of Patient Factors in Symptoms
    • Q: What played a more significant role in post-URS stent symptoms, patient factors or surgical factors?
A

A: Patient factors, like age and depression, were more significant.

20
Q
  1. Card 14: Older vs. Younger Patients in Symptom Severity
    • Q: How do older patients’ symptom experiences compare to younger patients following URS?
A

A: Older patients had lower pain intensity, but younger patients experienced greater symptom burden.

21
Q
  1. Card 15: Time Course of Pain and Urinary Symptoms
    • Q: How do pain and urinary symptoms evolve in the immediate postoperative period after URS and stent placement?
A

A: Pain intensity decreases rapidly by POD 5, but pain interference and urinary symptoms persist longer.

22
Q
  1. Card 16: Pain Interference and Daily Activities
    • Q: Despite a reduction in pain intensity, what symptom remains problematic after POD 5?
A

A: Pain interference with daily activities remains elevated.

23
Q
  1. Card 17: Role of BMI in Symptom Severity
    • Q: How does BMI affect post-URS symptoms?
A

A: Higher BMI is linked to greater urinary bother.

24
Q
  1. Card 18: Patient Counseling Importance
    • Q: What do the study’s findings suggest for patient counseling post-URS and stent placement?
A

A: Patients should be counseled on symptom persistence, particularly pain interference and the effects of age, chronic pain, and depression.

25
Q
  1. Card 19: Future Efforts in Reducing Stent Symptoms
    • Q: What future efforts are highlighted to mitigate the burden of stent-associated symptoms?
A

A: Prediction modeling for those at risk of severe pain and targeting patient factors like depression.

26
Q

Q: What is the primary purpose of ureteral stents after URS?

A

A: To ensure ureteral patency and facilitate healing if injury occurs.
Memory aid: Think of a “stent” like a “tent” that holds up the structure (ureter) while it heals.

27
Q

Q: How do stent-associated symptoms vary among patients?

A

A: Some patients tolerate stents well, while others experience severe pain and urinary symptoms that interfere with daily activities.
Memory aid: “Stent symptoms” can be either “silent” or a “storm” depending on the patient.

28
Q

Q: What is the primary purpose of ureteral stents following ureteroscopy (URS)?

A

A: Ureteral stents are used to maintain ureteral patency and aid healing if any ureteral injury occurs during the procedure.

29
Q

Q: Why is understanding the etiology of stent-associated symptoms difficult?

A

A: Understanding is challenging because there are multiple modifiable and non-modifiable risk factors, including patient demographics, baseline pain, psychosocial factors, stone characteristics, operative factors, stent characteristics, and medications.

30
Q

Q: List two modifiable and non-modifiable risk factors that affect stent-associated symptoms.

A
  • A:
    • Modifiable: Psychosocial factors (e.g., depression), medications.
    • Non-modifiable: Age, stone characteristics (e.g., size, location).
31
Q

Q: What is the overall aim of the STENTS study?

A
  • A: To identify risk factors for increased pain, pain interference, urinary symptoms, and bother following ureteroscopy (URS) and stent placement, and to inform future interventional studies.``
32
Q

Q: Which network conducted the STENTS study?``

A

A: The USDRN (Urinary Stone Disease Research Network) conducted the study.

33
Q

Q: What type of study was conducted in the STENTS study?

A

A: A prospective, observational cohort study.

34
Q

Q: Why are modifiable risk factors important in managing stent-associated symptoms?

A

A: Modifiable factors such as psychosocial health and medications can be adjusted to reduce symptom burden and improve patient outcomes.

35
Q

Q: How can understanding non-modifiable factors help clinicians in managing stent-associated symptoms?

A
  • A: Knowing non-modifiable factors, such as a patient’s demographics or stone characteristics, helps identify individuals who are more likely to experience severe symptoms, allowing for better patient counseling and symptom management.
36
Q
  1. Q: Why is symptom burden such a significant issue for patients with ureteral stents?
    • A: Because stent-associated pain and urinary symptoms can significantly affect quality of life and daily activities, leading to poor patient outcomes if not properly managed.
A

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