RecruitingACTRN12621001528842

Patient preference and safety of self-removal of ureteric stents

Efficacy and safety of ureteric stents in patients who have recently undergone ureteroscopy for stone disease

Sponsor

Royal North Shore Hospital

Enrollment

180 participants

Start Date

Oct 15, 2021

Study Type

Interventional

Conditions

Ureteroscopy Nephrolithiasis Urolithiasis

Summary

Following treatment of urinary tract stones, ureteric stents are typically left in for one to two weeks post-operatively. Removal of these stents can be performed in multiple ways - either by the patient themselves, by a nurse or via a subsequent procedure. This study investigates these methods of ureteric stent removal to see which is better tolerated by patients. We hypothesise that self-removal of ureteric stents will be preferable. This is because of convenience, reducing risk of potential exposure to COVID-19 and reducing hospital costs.

Eligibility

Sex: Both males and femalesMin Age: 20 YearssMax Age: 70 Yearss

Plain Language Summary

Simplified for easier understanding

After surgery to treat kidney stones, surgeons often place a small tube called a ureteric stent inside the ureter (the tube connecting the kidney to the bladder) to help it heal. After one to two weeks, the stent needs to come out. This can be done in three ways: by a nurse in a clinic, through a brief hospital procedure, or by the patient themselves using an attached string. This study is comparing patient comfort and preference across these three removal methods. Researchers think that self-removal will actually be preferred by many patients because it is convenient, avoids a hospital visit, and empowers patients to take charge of their own recovery. Given the COVID-19 pandemic also highlighted the risks of unnecessary hospital attendance, finding safer home-based alternatives is increasingly important. You may be eligible if you are aged 20–70, are having elective surgery for kidney or ureteric stones where a stent will be placed, and are independent in your daily activities. People with stents placed for cancer, kidney disease, or ureteric strictures, or whose stents have been in place for more than two weeks, are not eligible.

This is a simplified summary. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

Self-removal of ureteric stents via string extraction by patients The process of ureteric stent removal involves patients being given both written (public), verbal (private) and video information (

Self-removal of ureteric stents via string extraction by patients The process of ureteric stent removal involves patients being given both written (public), verbal (private) and video information (private) - which has been designed specifically for this study. Participants will be provided with a link to view the video after their appointment. The video duration is approximately 2 minutes. The instructions for ureteric stent removal by patient are as follows: 1. Wash your hands 2. Stand up to remove 3. To remove the stent, the visible string is held firmly and a steady, continuous pulling action should be applied until the entire stent comes out. The stent is flexible and should uncurl and come out easily. 4. Check the stent has been completely removed - blue plastic tube approximately 20cm long 5. Expect some mild discomfort in your back and urethra on removal. A small amount of blood in the urine is normal after removal but should settle. If there are any concerns regarding the stent removal, please contact the Urology Registrar at Royal North Shore Hospital. This information above is provided on a written handout which also has the time and date of stent removal for patients. I.e Remove on Monday the 18th October at 0900am Patients will remove the stent in their own home. Other methods of removal include by a nurse in an outpatient clinic/surgeons' rooms or via a flexible cystoscopy performed either in hospital theatre or in the outpatient clinic Patients are self-selecting method of removal. Patients will submit a questionnaire and be called by the Primary Investigator 1 week following stent removal. Stents are being left generally for 3-5 days post procedure