Patient-centered outcomes of double-J ureteral stents: Symptom frequency and satisfaction in a resource-limited healthcare system.

Abstract

Objective: This study aimed to quantify the prevalence and severity of indwelling double-J (DJ) ureteral stent-related symptoms, characterize pain perception, and evaluate patient satisfaction among adult patients in a resource-limited healthcare system, while identifying demographic and clinical factors associated with symptom burden and satisfaction.

Methods: A cross-sectional study was conducted between April and December 2025 at two major urology centers. Patients who underwent DJ ureteral stenting for ureteral obstruction, predominantly due to urinary tract stones, were consecutively recruited. Data were collected using a structured, seven-part questionnaire assessing urinary symptoms, pain characteristics, quality of life, and satisfaction, supplemented by clinical information from electronic medical records. Pain intensity was measured using a visual analogue scale (VAS).

Results: Among 200 patients analyzed, stent-related symptoms were highly prevalent. The median stent indwelling duration was 30.0 days [IQR: 19.0-41.0]. Flank or abdominal pain was reported by 176 patients (88%), with a median severity of 6.0 on the VAS. Other frequent complaints included fatigue (74%), sleep disturbance (71.5%), urinary frequency (70.5%), dysuria (69%), hematuria (58%), and sensation of a foreign body (65.5%). Despite this substantial symptom burden, overall satisfaction was relatively high: 124 patients (62%) reported being satisfied or very satisfied, and 134 (67%) expressed willingness to undergo stenting again if medically indicated. Longer stent indwelling time was independently associated with increased flank pain (OR 1.05/day, 95% CI 1.01-1.09, p = 0.007) and satisfaction was negatively associated with comorbidities (β = -0.17, p = 0.027).

Conclusion: DJ ureteral stents cause significant pain, urinary symptoms, and quality-of-life impairment among Palestinian patients, yet overall satisfaction remains high, reflecting recognition of their clinical necessity. These findings highlight the need for better counseling, tailored symptom management, and structured follow-up to strengthen patient-centered care.