A randomized controlled trial comparing hydrophilic coated to uncoated polyurethane double J stents: Does it impact stent-related symptoms?

Introduction: Advancements in stent materials and designs are aimed at improving stent-related morbidities, lower urinary tract symptoms (LUTSs), pain, and compromised quality of life (QoL). Various stent materials and coatings have been investigated for their impact on stent-related symptoms. This prospective randomized study aimed to compare urinary symptoms and QoL in patients with polyurethane double J (DJ) stents, with or without hydrophilic polyvinylpyrrolidone coating.

Materials and methods: Sixty adult patients undergoing endourological procedures and DJ stent placement were randomized into two groups in 2:1 ratio. In 20 patients, polyurethane stents with hydrophilic coating and in 40 patients, stents without hydrophilic coating were placed. In all patients, a stent of 5F diameter and 26 cm length was used. Urinary symptoms, pain, and QoL were assessed at the time of stent removal, i.e., at 3-4 weeks using the validated ureteral stent symptom questionnaire (USSQ).

Results: The demographic data were comparable in both groups. Patients with hydrophilic stents reported significantly fewer urinary symptoms (mean score 10.75 vs. 15.28, P < 0.001), lower pain scores (1.50 vs. 3.18, P < 0.001), and better QoL scores (3.0 vs. 5.23, P < 0.001). Symptoms such as frequency, nocturia, urgency, and burning micturition were notably reduced in the hydrophilic group. In addition, 60% of patients in the hydrophilic group reported no pain compared to only 7.5% in the nonhydrophilic group (P < 0.001).

Conclusion: Hydrophilic-coated DJ stents significantly alleviate LUTS and improve QoL, warranting further large-scale research to validate these findings. These findings align with previous studies suggesting that hydrophilic coatings improve stent-related outcomes.