Ureteral stents following ureteroscopy (URS) are frequently associated with pain, lower urinary tract symptoms (LUTS), and unplanned healthcare utilisation. Digital eHealth pathways may allow early symptom detection and targeted intervention. This study prospectively evaluated a QR-linked symptom diary with automated clinician notification following URS and stent insertion

A prospective single-centre pilot study was conducted including 25 consecutive patients undergoing URS with stent placement. Patients were enrolled at discharge and provided access to a QR-linked eHealth diary (Microsoft Forms platform), accessible via smartphone. Patients completed daily entries for 7 days, capturing pain (visual analogue scale, VAS), LUTS (adapted IPSS domains), haematuria, and quality of life (QoL).

Predefined thresholds (VAS ≥6, severe LUTS, or worsening QoL) triggered automated alerts sent via secure NHS email to the urology team. Responses were delivered through structured pathways: reassurance emails, telephone review within 24 hours, or expedited clinic review if required. Primary outcomes included symptom trajectory and unplanned healthcare utilisation. Secondary outcomes included response time, patient engagement, and safety.

Twenty-five patients (mean age 52±11 years) completed the study, with 92% adherence to ≥5 diary entries. Symptom curves demonstrated a peak in pain and LUTS at postoperative day 2–3, followed by progressive decline by day 5–7. Mean VAS decreased from 5.2 (day 1) to 2.3 (day 7), while LUTS scores improved from 14 to 9.

A total of 14 alerts were triggered in 10 patients (40%). Responses were delivered via email reassurance (n=8), telephone consultation (n=5), and early face-to-face review (n=1). Median clinician response time was 5.5 hours. Unplanned emergency department attendance occurred in 1 patient (4%), lower than expected institutional baseline (~15–20%). No adverse safety events were observed.

A QR-linked eHealth symptom monitoring system following URS and stent insertion is feasible, safe, and highly acceptable. Symptom trajectory curves highlight a predictable early postoperative peak, enabling targeted intervention. Automated email-triggered clinician responses allow efficient triage without increasing workload. This approach represents a scalable, low-cost strategy to improve post-stent care and reduce unnecessary acute presentations.