Comparative analysis of loop-tail versus double J ureteral stents in diabetic patients: effects on stent-related symptoms and encrustations

To evaluate stent-related symptoms (SRS) and the encrustation of stents in diabetic patients receiving loop-tail (LT) stents versus conventional double J (DJ) stents following uncomplicated flexible ureterorenoscopy (fURS). This study retrospectively analyzed data collected from diabetic patients who underwent fURS between July 2022 and May 2025. A total of 108 patients were eligible in this study, including 56 patients received conventional DJ stents and 52 patients received LT stents. Stent-related symptoms were assessed using the Chinese validated version of the Ureteric Stent Symptom Questionnaire (USSQ) at 3 day and 4 weeks post-stent insertion. Encrustation of stents was assessed upon stent removal. Statistical analyses were conducted to compare USSQ domains, encrustation scores, and complications between the two groups. There were no significant differences between the two groups in USSQ domains at 3 days post-stent insertion. At 4 weeks, the LT group demonstrated a significantly better outcome in the urinary symptoms domain (P = 0.037) and visual analogue scale (VAS) for pain (P = 0.042) compared with the DJ group. Patients in the LT group reported lower scores of urinary frequency (P = 0.003), incomplete emptying (P = 0.031), burning at voiding (P = 0.047), and pain interfering with life (P = 0.015) than those in the DJ group. Encrustation scores in bladder segment were significantly lower in the LT group than in the DJ group (p < 0.001). No significant differences were found between the two groups in the incidence of stent-related complications. In diabetic patients, LT stents are associated with fewer stent-related urinary symptoms and less pain. They also show lower encrustation scores compared to conventional DJ stents at 4 weeks post-insertion. LT stents may be a preferable option for LT stent placement in diabetic patients undergoing fURS.