Is there any relationship between ureteral DJ stent colonization and lower urinary tract symptom severity?

Abstract

Aim: The purpose of this study is to evaluate risk factors for, and the relationship between, lower urinary tract symptoms (LUTS) and double J stent (DJS) colonization. Material and Methods: One hundred and thirty five patients aged 18 to 77 were included in this prospective study conducted at Urology Clinic in our university hospital between July 2012 and December 2013. Patients were followed clinically; we recorded any bothersome symptoms after treatment. Stents were removed under aseptic conditions. Their distal ends were removed and placed in a culture medium for evaluation. The relationship between colonization and LUTS was evaluated. Results: Bacteriuria and stent colonization were found in 10 (7.4%) and 35 (26%) patients, respectively. In the colonized stents, Candida spp. was the most commonly observed pathogen (40%). Mean indwelling times were different for the colonized (68.6 days) and non-colonized (46.2 days) groups. Similarly, the encrustation rate was significantly higher in colonized patients (42.8%) than in non-colonized cases (27%). In the colonized group, rates were significantly higher for irritative voiding symptoms such as polyuria (57.1% vs. 31%), nocturia (71.4% vs. 57%), and urgency (54.2% vs. 33%). Conclusions: LUTS, especially irritative voiding symptoms including polyuria and nocturia, are more frequent in patients with stent colonization. Patients at risk of stent colonization should be followed up for the development of infections, and prophylactic treatment should be administered. In addition, indwelling time may be shortened to prevent colonization.