Analysis Of Risk Factors Of Ureteral Stent-related Pain In Postoperative Patients With Upper Urinary Tract Calculi

Background:Upper urinary tract calculi is one of the most common diseases in urology.With the continuous progress of intracavitary technology,minimally invasive surgery has become the main treatment of upper urinary tract calculi.Since finney first used the modern ureteral stent in clinic in 1978,ureteral stent is an indispensable important tool in most urological stone surgery at present.However,with the widespread use of ureteral stents,ureteral stent-related symptoms are reported more and more frequently by clinicians,including lumbar and abdominal pain,hematuria,bladder irritation,infection,sexual dysfunction and so on.Studies have shown that more than 80% of patients have severe pain after operation,which affects the quality of life of patients after operation.Therefore,how to avoid and reduce ureteral stent-related pain has important clinical significance.Objective: to analyze the independent risk factors of ureteral stent-related pain in postoperative patients with upper urinary tract calculi and to provide reference for clinicians to prevent and reduce postoperative ureteral stent-related pain.Methods: the clinical data of patients with upper urinary tract calculi treated by minimally invasive surgery from January 2019 to December 2019 were analyzed retrospectively,including 191 males and 125 females.The perioperative data such as age,BMI(Body Mass Index)and the location of stones were collected before operation,and the data of postoperative residual stone and postoperative pain score were collected after operation.The relationship between each index and ureteral stent-related pain in postoperative patients with upper urinary tract calculi was analyzed by univariate and multivariate logistic regression,and the independent risk factors were screened out.Results: among the 316 patients in this study,176 patients developed severe pain after operation,with an incidence of 55.7%.Univariate regression analysis showed that oral α-adrenoceptor blockers,body mass height index,postoperative residual stone,postoperative Systemic inflammatory response syndrome(SIRS),ureteral stricture were associated with pain in patients with upper urinary tract calculi.Multivariate regression analysis showed that oral α-receptor blockers were protective factors for pain in patients with upper urinary tract calculi after indwelling ureteral stents,while postoperative SIRS and ureteral stricture were risk factors.Stepwise regression prediction model: Logit(P)=-0.09934-1.36486 × postoperative oral α-blocker + 1.93909 × ureteral stricture + 1.57683 × postoperative SIRSConclusion: oral α-receptor blockers can reduce the risk of pain and postoperative pain in patients with upper urinary tract calculi after indwelling ureteral stents,while postoperative SIRS and ureteral stricture will increase the risk of pain and increase postoperative pain in patients with upper urinary tract calculi after indwelling ureteral stents.