فهرست نشریات علمی دسترسی آزاد ایران

Introduction: Double-J (DJ) ureteral stents are essential to modern urological therapy because they allow internal urine drainage in a variety of clinical contexts, such as obstructive uropathy, postoperative support, and short-term ureteral blockage alleviation. Despite advancements in design, material, and surface coatings since their initial description in 1967 and further refining in 1978, patient-reported discomfort is still a major problem with DJ stents.Methods: This review summarizes the most recent data about the causes, symptoms, complications, and pharmaceutical treatment of adverse effects associated with stents. A complex combination of ureteral smooth muscle spasm, vesicoureteral reflux, and mechanical irritation of the bladder caused by the distal coil contribute to the pathophysiology of ureteral stent-related symptoms (USRS).Results: Prevalence estimates vary from 50% to 80% across a range of patient demographics, and often reported symptoms include flank discomfort, hematuria, sexual dysfunction, and lower urinary tract symptoms (frequency, urgency, and dysuria). Especially when indwelling for longer than three months, complications include encrustation, biofilm formation, stent migration, fragmentation, and retained ("forgotten") stents increase morbidity. Pharmacological strategies aim to mitigate USRS by addressing the underlying mechanisms: neuropathic pain modulators (duloxetine, pregabalin) address central pain pathways; alpha-adrenergic antagonists (tamsulosin) decrease ureteral smooth muscle tone and reduce flank pain and urinary urgency; anticholinergics (solifenacin) attenuate detrusor overactivity and improve bladder storage symptoms; and β₃-adrenergic agonists (mirabegron) enhance detrusor relaxation with favorable tolerability; and neuropathic pain modulators (pregabalin) address central pain pathways. Randomized trials show that combination regimens (alpha-blocker plus anticholinergic) provide superior relief of irritative and voiding symptoms compared to monotherapy, with notable improvements in validated symptom scores and quality-of-life indices.Conclusion: For patients who need ureteral stenting, a multidisciplinary, patient-centered strategy that includes prompt stent removal, optimal medication, and careful monitoring is crucial to improving tolerability, lowering adverse events, and improving overall results.