FIRM VERSUS SOFT DOUBLE PIGTAIL URETERAL STENTS - A RANDOMIZED BLIND COMPARATIVE TRIAL

It is generally considered that 'firm' double pigtail ureteric cathete rs, while easier to insert and less prone to migration, may cause more patient discomfort than the 'softer' variety of stent. Objective supp ort for these perceptions is however lacking. The aim of this study wa s to compare firm and soft stents regarding their ease of insertion, p ositional stability, biocompatibility and patient tolerance. 155 patie nts were randomised to receive 'firm' (polyurethane, n = 78) or 'soft' (Sof-Flex, n = 77) stents. Ease and mode of insertion was recorded at time of initial placement. Positional stability, degree of bladder in flammation, stent encrustation and patient tolerance were recorded at the time of removal. Patient tolerance was assessed by symptom score i n double-blind fashion. Results showed no significant difference in ea se of insertion, positional stability, degree of bladder inflammation or stent encrustation between the two groups. There was a significantl y higher incidence of dysuria, renal and suprapubic pain in the firm s tent group. There was no significant difference in the incidence of ur gency, frequency, nocturia or haematuria. Normal activity and return t o work were reported in 67 and 45% of patients with soft and firm sten ts, respectively. The data indicates that patient tolerance appears to be related to the softness of the stent material.