A prospective evaluation of pain associated with stone passage, stents, and stent removal using a visual analog scale

Urology. 2013 Sep;82(3):521-5. doi: 10.1016/j.urology.2013.04.031. Epub 2013 Jun 14.


Objective: To investigate the perception of colicky pain due to ureteral stones and double-J (DJ)-associated discomfort and to evaluate the role of clinical parameters that might influence the perception of pain.

Materials and methods: From November 2011 to May 2012, 124 consecutive patients with colicky pain due to ureteral stones and ureteroscopic stone extraction underwent DJ stent placement. A visual analog scale (VAS) was used to assess the pain at ureteral colic, during indwelling DJ stent, and at DJ stent removal. The association of clinical data with pain scores was also analyzed.

Results: Pain perception at the time of colic did not vary according to sex (P = .804), age (P = .674), or DJ stent length (P = .389). Stone size (<4 mm) was a predictor of a high VAS score (P = .001). Patients with recurrent stone formation had significantly less pain at the time of colic (P = .004), and DJ stent removal (P = .004) than those with the first instance of stone formation. The clinical experience at cystoscopic DJ stent removal influenced pain perception (P <.001).

Conclusion: Using a VAS for the evaluation of pain perception is a valid method for the objectification of subjective discomfort. The VAS is an easy to administer scale and provides accurate information on the patients' status. Additional studies with larger cohorts focusing on pain perception using the VAS and other validated questionnaires are recommended to produce more consistent data.

MeSH terms

  • Adult
  • Aged
  • Device Removal / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / methods*
  • Pain Perception*
  • Recurrence
  • Renal Colic / etiology*
  • Stents / adverse effects
  • Ureteral Calculi / complications*
  • Ureteral Calculi / pathology
  • Ureteral Calculi / surgery
  • Ureteroscopy / adverse effects
  • Young Adult