Patient-Reported Stent Symptom Outcomes and Migration Rates Following Modified Single-J Ureteric Stent Insertion After Ureteroscopy: A Prospective Feasibility Study

Background/Objectives: Double-J stents (DJS) cause clinically significant lower urinary tract symptoms (LUTS) in 58–80% of patients following ureteroscopy (URS). The distal vesical coil is regarded as the primary anatomical source of trigonal irritation and detrusor instability. The single-J stent (SJS) eliminates this element while preserving the proximal renal pigtail for anti-migration anchorage. This study aimed to evaluate the safety and patient-reported symptom outcomes of a modified SJS compared with standard DJS following elective URS for ureteric stone disease. Methods: A prospective, single-arm, within-patient feasibility study was conducted in 28 adults undergoing elective URS at Austin Health, Melbourne, Australia (Human Research Ethics Committee (HREC)/25658/Austin-2025; NCT07535580). A modified SJS was fashioned from a commercially available 7Fr Bander™ ureteral diversion stent (Cook Medical, G14780) by trimming the shaft to 28 cm and affixing a 7 cm Prolene retrieval suture (Ethicon NW807) to the blunt distal end. The primary outcome was a cystoscopically confirmed SJS migration rate at removal (pre-specified feasibility threshold ≤5%). Secondary outcomes included change in Ureteral Stent Discomfort Test (USDT) total and domain scores (paired analysis, n = 24), adverse events, and patient preference. Results: The clinically significant migration rate was 0% (0/28); 27/28 stent tips were freely floating within the bladder, with one asymptomatic tip at the ureteric orifice at the scheduled removal visit. Mean total USDT score decreased from 39.92 ± 2.00 (DJS) to 30.42 ± 1.73 (SJS)—a mean absolute reduction of 9.50 points (23.8%; p < 0.001), a magnitude consistent with clinically relevant change, although a USDT-specific minimum clinically important difference has not been independently validated. All six USDT domains improved significantly (all p ≤ 0.014). No adverse events were recorded. All 28 patients (100%) reported they would choose the SJS again. Conclusions: The modified SJS demonstrated a favourable safety profile and was associated with lower patient-reported symptom scores than the preceding DJS across all USDT domains in this uncontrolled within-patient comparison. Because stent design, stone burden, and dwell time differed between the two assessment phases, these differences should be regarded as hypothesis-generating and provide a feasibility basis for a prospective randomised controlled trial evaluating the SJS following URS.