Abstract
OBJECTIVE: 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). PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12894-026-02087-4.