LAUSR

Double J (DJ) ureteral stents are often placed after ureteroscopy [1], even though randomised prospective trials have shown that routine stenting after uncomplicated ureteroscopy is not necessary [2]. The EAU guidelines state that stents should be inserted in patients who are at increased risk of complications, such as where there has been ureteral trauma, significant bleeding or a history of infection, pregnancy or where there are residual fragments [2]. As stents cause significant pain and urinary symptoms and negatively affect the patient’s quality-of-life, there has been much research undertaken to try and identify which factors relating to stent design and placement are most significant in contributing to these symptoms and whether the use of concomitant medication may help alleviate some of those symptoms. The distal end of the stent may be the most significant contributing factor to stent-related symptoms, so some studies have focussed on this aspect of stent design as being critical in trying to reduce symptoms. A recently designed stent, the JFil, named the ‘pigtail suture stent’ (PSS), has been introduced with this in mind. The JFil stent consists of a 7 Fr 16 cm body, featuring a fluted beak at the distal end and two simple sutures that reach the bladder and replace the distal part of a traditional DJ stent. Is it better or not?