BLUES trial: Silicone stents may improve patient care

In a recent interview, John Michael DiBianco, MD, an assistant professor of urology at the University of Florida in Gainesville, discussed findings from the BLUES trial presented at 40th Annual European Association of Urology Congress in Madrid, Spain. The study compared patient experiences with silicone vs polyurethane ureteral stents. The investigators found that patients with silicone stents reported fewer negative feelings about future stenting at 4–6 weeks post-procedure. DiBianco emphasized the potential long-term impact of this finding on patient adherence to treatment and overall satisfaction. He noted that improving the stenting experience could make patients more receptive to future urological interventions, which is significant considering the typically negative perception many have of stents.

The study was a multicenter, pragmatic randomized controlled trial conducted within the MUSIC (Michigan Urological Surgery Improvement Collaborative) network. DiBianco praised the diversity of participating sites—from academic centers to private practices—highlighting the potential generalizability of results. However, he cautioned that participants in MUSIC tend to be more engaged and possibly more current with advanced techniques, which could slightly limit applicability to broader, more heterogeneous urological practices, especially those serving underrepresented populations.

In terms of clinical impact, DiBianco shared that he already leans toward using silicone stents in his practice when no contraindications exist, as patients generally report greater comfort compared to polyurethane. He also reflected on study design, noting that shorter surveys used to minimize patient burden may have missed subtle differences in patient experiences. Moving forward, he advocates for the development of more sensitive, targeted patient-reported outcome measures. Additionally, future research could explore stent tolerance across broader populations and refine post-operative strategies based on stent material.

REFERENCE

1. DiBianco JM, Daignault-Newton S, Shoemaker E, et al. Is there a better stent? The Better Lithotripsy and Ureteroscopy Evaluation of Stenting (BLUES) randomized clinical trial comparing the patient experience of silicone vs polyurethane stents. Presented at: 40th Annual European Association of Urology Congress. March 21-24, 2025. Madrid, Spain. Abstract LB2. https://urosource.uroweb.org/resource-centres/EAU25/263407/abstract