References

Abdelaal AM, Al-Adl AM, Abdelbaki SA, Al Azab MM, Al Gamal KA. Efficacy and safety of tamsulosin oral-controlled absorption system, solifenacin, and combined therapy for the management of ureteric stent-related symptoms. Arab J Urol. 2016; 14:(2)115-122 https://doi.org/10.1016/j.aju.2016.01.004

A Likert analysis about double J stent related urinary symptoms assessed by the Ureteric Stent Symptoms Questionnaire (USSQ) after semirigid and flexible ureteroscopy (RIRS). 2017. https://www.eusupplements.europeanurology.com/article/S1569-9056(17)30296-8/abstract

A patient centred view of clinician-patient relationship. 2018. http://tinyurl.com/yyygrltz (accessed 25 April 2019)

Dellis AE, Keeley FX, Manolas V, Skolarikos AA. Role of a-blockers in the treatment of stent-related symptoms: a prospective randomized control study. Urology. 2014; 83:(1)56-62 https://doi.org/10.1016/j.urology.2013.08.067

Finney RP. Experience with double J ureteral catheter stents. Urol Clin North Am. 1982; 9:(1)89-94

Heidegger M. Being and time.New York (NY): Harper & Row; 1962

Hekal IA. Drug treatment of bothersome lower urinary tract symptoms after ureteric JJ-stent insertion: A contemporary, comparative, prospective, randomised placebo-controlled study, single-centre experience. Arab J Urol. 2016; 14:(4)262-268 https://doi.org/10.1016/j.aju.2016.08.004

Irani J, Siquier J, Pirès C, Lefebvre O, Doré B, Aubert J. Symptoms characteristics and the development of tolerance with time in patients with indwelling double-pigtail ureteric stents. BJU Int. 1999; 84:(3)276-279

Joshi HB, Newns N, Stainthorpe A, Macdonagh RP, Keeley FX, Timoney AG. The development and validation of a patient-information booklet on ureteric stents. BJU Int. 2001; 88:(4)329-334 https://doi.org/10.1046/j.1464-410X.2001.02356.x

Joshi HB, Okeke A, Newns N, Keeley FX, Timoney AG. Characterization of urinary symptoms in patients with ureteral stents. Urology. 2002; 59:(4)511-516 https://doi.org/10.1016/S0090-4295(01)01644-2

Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX, Timoney AG. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol. 2003; 169:(3)1060-1064 https://doi.org/10.1097/01.ju.0000049198.53424.1d

Kafle NP. Hermeneutic phenomenological research method simplified. Bodhi: An Interdisciplinary Journal. 2011; 2:181-201 https://doi.org/10.3126/bodhi.v5i1.8053

Lamb AD, Vowler SL, Johnston R, Dunn N, Wiseman OJ. Meta-analysis showing the beneficial effect of a-blockers on ureteric stent discomfort. BJU Int. 2011; 108:(11)1894-1902 https://doi.org/10.1111/j.1464-410X.2011.10170.x

Miles M, Chapman Y, Francis K. Peeling the onion: understanding others' lived experience. Contemp Nurse. 2015; 50:(2-3)286-295 https://doi.org/10.1080/10376178.2015.1067571

Placement and management of indwelling ureteral stents. 2018. http://tinyurl.com/y2dmfdnp (accessed 25 April 2019)

Nevo A, Mano R, Baniel J, Lifshitz DA. Ureteric stent dwelling time: a risk factor for post-ureteroscopy sepsis. BJU Int. 2017; 120:(1)117-122 https://doi.org/10.1111/bju.13796

Shalaby E, Ahmed A, Maarouf A, Yahia I, Ali M, Ghobish A. Randomized controlled trial to compare the safety and efficacy of tamsulosin, solifenacin, and combination of both in treatment of double-J stent-related lower urinary symptoms. Adv Urol. 2013; https://doi.org/10.1155/2013/752382

EAU guidelines on urolithiasis. 2019. https://uroweb.org/guideline/urolithiasis/ (accessed 25 April 2019)

van Manen M. Researching lived experiences, human science for an action sensitive pedagogy, 2nd edn. London: Althhouse Press; 1997

van Manen M. Phenomenology in its original sense. Qual Health Res. 2017; 27:(6)810-825 https://doi.org/10.1177/1049732317699381

Wolderslund M, Kofoed PE, Holst R, Axboe M, Ammentorp J. Digital audio recordings improve the outcomes of patient consultations: A randomised cluster trial. Patient Educ Couns. 2017; 100:(2)242-249 https://doi.org/10.1016/j.pec.2016.08.029

Zimskind PD, Fetter TR, Wilkerson JL. Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol. 1967; 97:(5)840-844 https://doi.org/10.1016/S0022-5347(17)63130-6

Living with ureteric stents: a phenomenological study

09 May 2019
Volume 28 · Issue 9

Abstract

Background:

patients with ureteric stents (JJ stents) have reported symptoms such as voiding dysfunction, incontinence, depression and sexual dysfunction, which have impacted on their quality of life, since the procedure was first described by Zimskind in 1967.

Aim:

the aim of this study was to enhance understanding of the lived experience of having a ureteric stent.

Method:

the research design used was hermeneutic interpretive phenomenology, underpinned by Heidegger's interpretive phenomenology.

Findings:

this phenomenological study found that ureteric stents have an impact on patients' quality of life. The five themes that emerged were: disruption to activities of daily life, burden on my physical body, burden on my mind, influence of time and influence of others.

Conclusion:

urological nurses can enhance the patient's experience of living with a ureteric stent by educating patients regarding stent symptoms and management, giving psychological support and advocating for the patient with adverse stent-related symptoms.

The development of ureteric stents to relieve ureteric obstruction secondary to renal stones, renal masses or congenital abnormalities revolutionised urological interventions in the late 1960s (Finney, 1982). Ureteric stents, also referred to as ‘JJ’ stents or ‘double J’ stents, can have a negative impact on patient's lives, causing symptoms such as frequency, dysuria, nocturia, decreased libido, infection and depression (Joshi et al, 2002; Bosio et al, 2017). This phenomenon has been studied since 1967 when the long-term indwelling ureteral splint inserted cystoscopically was described by PD Zimskind (Zimskind et al, 1967). Shalaby et al (2013) noted that symptoms in patients with ureteral stents are inevitable and approximately 80% of patients with ureteral stents report adverse symptoms, which can vary in intensity. Numerous studies concurred with Shalaby et al (2013) on the benefit of alpha blockers and antimuscarinics for relief of ureteric stent-related symptoms (Dellis et al, 2014; Abdelaal et al, 2016; Hekal, 2016). The European Association of Urology urolithiasis guidelines advocate the use of alpha blockers in ureteric stent symptom management (Türk et al, 2019). Despite these recommendations patients with ureteric stents continue to experience quality of life issues while living with stents.

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content