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Pricop C, Bandac CA, Ivanuță M, Rădăvoi D, Jinga V, Puia D. Comparative Approaches in Treating Double-J Stent Syndrome: Monotherapy or Combination Therapy? J Clin Med 2024; 13:4278. [PMID: 39064317 PMCID: PMC11278051 DOI: 10.3390/jcm13144278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/08/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Introduction: The application of double-J ureteral stents in urology is widespread, but their use is often accompanied by complications and bothersome symptoms, affecting patients' quality of life (QoL). While various medications have been tested for alleviating the symptoms associated with double-J stents, consensus on their effectiveness remains elusive. This study aims to investigate the effectiveness of tamsulosin, solifenacin, mirabegron, desloratadine, and combination therapy using a Romanian-adapted version of the Ureteral Stent Symptom Questionnaire (USSQ). Materials and Methods: A prospective, observational, randomised trial was conducted at the Urology and Renal Transplant Clinic of Dr. "C.I. Parhon" Clinical Hospital in Iasi between 1 January 2022 and 1 August 2023. Three hundred twenty seven patients who underwent their first double-J stent insertion were evaluated with the Romanian-adapted USSQ at baseline and 30 days post-insertion. Patients were randomly divided into six groups based on the prescribed medications: control, tamsulosin, mirabegron, solifenacin, desloratadine, and combination therapy. Results: The data suggest a significant reduction in symptoms in patients who received medication compared with the control group. Furthermore, the combined medication of solifenacin 10 mg and tamsulosin 0.4 mg was particularly effective in reducing pain with statistical significance compared to the control group (p = 0.001). The highest mean scores for urinary symptom severity were observed in the control group (12.37 ± 6.82), and the lowest was in the mirabegron group (9.94 ± 5.82). The individuals who received a daily dose of 50 mg of mirabegron saw the most notable influence on their job. Conclusions: While no single medication emerged as a "miracle drug" for managing symptoms related to double-J stent insertion, the combination therapy of solifenacin and tamsulosin is the most promising option for improving symptoms related to double-J stent insertion and QoL. Additional extensive research is required to validate these initial results.
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Affiliation(s)
- Cătălin Pricop
- “Grigore T Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Urology, “Dr. C.I. Parhon” Clinical Hospital, 700503 Iasi, Romania
| | | | - Marius Ivanuță
- “Grigore T Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Urology, “Dr. C.I. Parhon” Clinical Hospital, 700503 Iasi, Romania
| | - Daniel Rădăvoi
- Department of Urology, “Theodor Burghele” Clinical Hospital, 050653 Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, 050653 Bucharest, Romania
| | - Viorel Jinga
- Department of Urology, “Theodor Burghele” Clinical Hospital, 050653 Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, 050653 Bucharest, Romania
| | - Dragoş Puia
- “Grigore T Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Urology, “Dr. C.I. Parhon” Clinical Hospital, 700503 Iasi, Romania
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Liu M, Liu S, Mao Q, Zou Q, Cui Y, Wu J. Comparison of the efficacy and complications of tolterodine and α-adrenergic receptor blockers in improving ureteral stent-related symptoms: A systematic review and meta-analysis. PLoS One 2024; 19:e0302716. [PMID: 38701097 PMCID: PMC11068181 DOI: 10.1371/journal.pone.0302716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE We conducted a systematic evaluation of the therapeutic efficacy and complications of tolterodine and α-adrenergic receptor blockers in alleviating ureteral stent-related symptoms. METHODS Until August 2023, we conducted a comprehensive literature search on PubMed, Embase, Web of Science, and Cochrane Library to identify randomized controlled trials evaluating the efficacy and complications of tolterodine and α-adrenergic receptor blockers in treating ureteral stent-related symptoms. Two reviewers independently screened studies and extracted data. The scores from various domains of the Ureteral Stent Symptom Questionnaire (USSQ) were summarized and compared, and statistical analysis was performed using RevMan 5.4.0 software. RESULTS A total of 8 studies met the inclusion criteria for our analysis. These studies were conducted at different centers. All studies were randomized controlled trials, involving a total of 487 patients, with 244 patients receiving α-adrenergic receptor blockers and 243 patients receiving tolterodine. The results showed that tolterodine demonstrated significantly better improvement in body pain (MD, 1.56; 95% CI [0.46, 2.66]; p = 0.005) (MD, 0.46; 95% CI [0.12, 0.80]; p = 0.008) (MD, 3.21; 95% CI [1.89, 4.52]; p = 0.00001) among patients after ureteral stent placement compared to α-adrenergic receptor blockers at different time points. Additionally, at 4 weeks, tolterodine showed superior improvement in general health (MD, 0.15; 95% CI [0.03, 0.27]; p = 0.01) and urinary symptoms (MD, 1.62; 95% CI [0.59, 2.66]; p = 0.002) compared to α-adrenergic receptor blockers, while at 6 weeks, tolterodine showed better improvement in work performance (MD, -1.60; 95% CI [-2.73, -0.48]; p = 0.005) compared to α-adrenergic receptor blockers. Additionally, the incidence of dry mouth (RR, 4.21; 95% CI [1.38, 12.87]; p = 0.01) is higher with the use of tolterodine compared to α-adrenergic receptor blockers. However, there were no significant statistical differences between the two drugs in other outcomes. CONCLUSION This meta-analysis suggests that tolterodine is superior to α-adrenergic receptor blockers in improving physical pain symptoms after ureteral stent placement, while α-adrenergic receptor blockers are more effective than tolterodine in enhancing work performance. Additionally, the incidence of dry mouth is higher with the use of tolterodine compared to α-adrenergic receptor blockers. However, higher-quality randomized controlled trials are needed to further investigate this issue.
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Affiliation(s)
- Ming Liu
- Second Clinical Medical College, Binzhou Medical University, Yantai, Shandong, China
- Department of Urology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Shangjing Liu
- Department of Urology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Qiancheng Mao
- Department of Urology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Qingsong Zou
- Department of Urology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Yuanshan Cui
- Department of Urology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Jitao Wu
- Department of Urology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
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Scotland KB, Almutairi K, Park E, Wang L, Kung SHY, Haegert A, Adomat H, Bell R, LeBihan S, Chew BH, Lange D. Indwelling stents cause obstruction and induce ureteral injury and fibrosis in a porcine model. BJU Int 2023; 131:367-375. [PMID: 36181708 DOI: 10.1111/bju.15912] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate global changes in ureters at the transcriptional, translational and functional levels, both while stents are indwelling and after removal and recovery, and to study the effects of targeting pathways that play a potential role. METHODS Pig ureters were stented for varying amounts of time (48 h, 72 h, 14 days) and the impact on peristalsis, dilatation and hydronephrosis were assessed. RNAseq, proteomic, histological and smooth muscle (SM) function analyses were performed on ureteric and kidney tissues to assess changes induced by stenting and recovery. Pathway analysis was performed using Ingenuity Pathway Analysis software. To study the impact of possible interventions, the effects of erythropoeitin (EPO) and a Gli1 inhibitor were assessed. RESULTS Stenting triggers massive ureteric dilatation, aperistalsis and moderate hydronephrosis within 48 h. Pathways associated with obstruction, fibrosis and kidney injury were upregulated by stenting. Increased expression of GLI1, clusterin-α (a kidney injury marker) and collagen 4A2 (a fibrosis marker) was found in stented vs contralateral unstented ureters. EPO did not improve peristalsis or contraction force but did decrease non-purposeful spasming seen exclusively in stented ureters. Tamsulosin administration increased contractility but not rate of peristalsis in stented ureters. CONCLUSIONS Ureters respond to stents similarly to how they respond to an obstruction, that is, with activation of pathways associated with hydronephrosis, fibrosis and kidney injury. This is driven by significant dilatation and associated ureteric SM dysfunction. EPO and tamsulosin induced mild favourable changes in SM physiology, suggesting that targeting specific pathways has potential to address stent-induced complications.
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Affiliation(s)
- Kymora B Scotland
- Department of Urology, University of California Los Angeles, Los Angeles, CA, USA
| | - Khaled Almutairi
- Department of Urologic Sciences, The Stone Centre at Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.,College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Elliya Park
- Department of Urologic Sciences, The Stone Centre at Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Lu Wang
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Sonia H Y Kung
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Anne Haegert
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Hans Adomat
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Robert Bell
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Stephane LeBihan
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Ben H Chew
- Department of Urologic Sciences, The Stone Centre at Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Dirk Lange
- Department of Urologic Sciences, The Stone Centre at Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
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Taguchi M, Yasuda K, Kinoshita H. Prospective randomized controlled trial comparing a ureteral stent crossing versus not crossing the bladder midline. World J Urol 2022; 40:1537-1543. [PMID: 35294582 PMCID: PMC8924725 DOI: 10.1007/s00345-022-03978-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/24/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the correlation between the position of a ureteral stent and stent-related symptoms in a single-center randomized study. METHODS A total of 113 patients who required ureteral stent placement after lithotripsy were randomized at a 1:1 ratio into groups with stents crossing and not crossing the bladder midline. The ureteral stent remained in place until postoperative day 14, when we obtained each patient's International Prostate Symptom Score (IPSS), overactive bladder symptom score (OABSS), and visual analog scale (VAS) pain score. RESULTS Comparing changes from baseline IPSS and OABSS scores between the two groups, the midline crossing group had a worse OABSS total score than the not crossing group (3.0 ± 2.8 vs. 2.0 ± 3.3; p = 0.032). There was no significant difference between the crossing and not crossing groups in IPSS total score (6.8 ± 7.6 vs. 5.1 ± 8.5; p = 0.14). The OABSS urgency mean score was significantly lower in the not crossing than in the crossing group (1.1 ± 1.8 vs. 1.6 ± 1.8; p = 0.042). However, there was no significant difference between groups for remaining items of the IPSS and OABSS and the mean VAS total pain score (1.9 ± 2.7 vs. 1.2 ± 1.9; p = 0.14). CONCLUSION A ureteral stent that crossed the bladder midline led to worse urinary symptoms. Choosing the appropriate stent length for each patient is important to minimize stent-related symptoms. TRIAL REGISTRATION DATE 1 October 2018; number: UMIN000034067.
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Affiliation(s)
- Makoto Taguchi
- Department of Urology, Osaka Saiseikai Izuo Hospital Based On Social Welfare Organization Saiseikai Imperial Gift Foundation Inc, Osaka, Japan
- Department of Urology and Andrology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010 Japan
| | - Kaneki Yasuda
- Department of Urology, Osaka Saiseikai Izuo Hospital Based On Social Welfare Organization Saiseikai Imperial Gift Foundation Inc, Osaka, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010 Japan
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Cinar O, Tanidir Y, Ozer S, Cizmeci S, Erbatu O, Ozdemir T, Girgin R, Ongun S, Ucer O, Kizilay F, Sen V, Irer B, Bozkurt O. Effects of mirabegron on JJ stent-related symptoms: A multicentric study. Int J Clin Pract 2021; 75:e13857. [PMID: 33230894 DOI: 10.1111/ijcp.13857] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/16/2020] [Indexed: 12/28/2022] Open
Abstract
AIMS OF THE STUDY To investigate the effect of mirabegron 50 mg/daily for JJ stent-related symptoms after ureteroscopic stone surgery. METHODS Medical records of 145 patients who were given a single daily oral dose of 50 mg of mirabegron for relieving stent-related symptoms were retrospectively analysed. Demographic and clinical data and stone parameters were recorded. All participants completed the Turkish version of the Ureter Symptom Score Questionnaire (USSQ-T) on the postoperative 7th day, and again after at least 3 weeks, before JJ stent removal. The severity of stent-related symptoms was statistically compared before and after the mirabegron treatment. RESULTS The mean urinary symptoms score decreased significantly from 30.87 ± 9.43 to 22.61 ± 6.78 (P < .0001), mean body pain score decreased significantly from 21.82 ± 11.22 to 14.03 ± 7.52 (P < .0001), mean work performance score decreased from 10.50 ± 8.61 to 7.02 ± 6.51 (P < .0001) and mean general health score decreased significantly from 15.43 ± 6.50 to 11.12 ± 3.70 (P < .0001). The mean sexual matters score significantly decreased from 3.88 ± 3.40 to 2.48 ± 2.03 (P < .0001), the additional problem score decreased from 9.31 ± 4.61 to 6.51 ± 2.83 (P < .0001) and the overall quality of life (QoL) score decreased from 5.18 ± 1.94 to 4.23 ± 1.71 after mirabegron use (P < .0001). CONCLUSION Daily use of 50 g of mirabegron significantly improved stent-related symptoms, sexual matters and quality of life.
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Affiliation(s)
- Onder Cinar
- Department of Urology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Yiloren Tanidir
- Department of Urology, Marmara University Istanbul Pendik Education and Research Hospital, Istanbul, Turkey
| | - Selcuk Ozer
- Department of Urology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Sezer Cizmeci
- Department of Urology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Oguzcan Erbatu
- Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Turan Ozdemir
- Department of Urology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Reha Girgin
- Department of Urology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Sakir Ongun
- Department of Urology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Oktay Ucer
- Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Fuat Kizilay
- Department of Urology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Volkan Sen
- Department of Urology, Manisa State Hospital, Manisa, Turkey
| | - Bora Irer
- Izmir Metropolitan Municipality Esrefpasa Hospital, Izmir, Turkey
| | - Ozan Bozkurt
- Department of Urology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Lee CX, Cheah JH, Soule CK, Ding H, Whittaker CA, Karhohs K, Burds AA, Subramanyam KS, Carpenter AE, Eisner BH, Cima MJ. Identification and local delivery of vasodilators for the reduction of ureteral contractions. Nat Biomed Eng 2019; 4:28-39. [PMID: 31792422 DOI: 10.1038/s41551-019-0482-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/15/2019] [Indexed: 01/23/2023]
Abstract
Kidney stones and ureteral stents can cause ureteral colic and pain. By decreasing contractions in the ureter, clinically prescribed oral vasodilators may improve spontaneous stone passage rates and reduce the pain caused by ureteral stenting. We hypothesized that ureteral relaxation can be improved via the local administration of vasodilators and other smooth muscle relaxants. Here, by examining 18 candidate small molecules in an automated screening assay to determine the extent of ureteral relaxation, we show that the calcium channel blocker nifedipine and the Rho-kinase inhibitor ROCKi significantly relax human ureteral smooth muscle cells. We also show, by using ex vivo porcine ureter segments and sedated pigs that, with respect to the administration of a placebo, the local delivery of a clinically deployable formulation of the two drugs reduced ureteral contraction amplitude and frequency by 90% and 50%, respectively. Finally, we show that standard oral vasodilator therapy reduced contraction amplitude by only 50% and had a minimal effect on contraction frequency. Locally delivered ureteral relaxants therefore may improve ureter-related conditions.
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Affiliation(s)
- Christopher X Lee
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.,David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jaime H Cheah
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Christian K Soule
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Huiming Ding
- The Barbara K. Ostrom (1978) Bioinformatics and Computing Facility in the Swanson Biotechnology Center, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Charles A Whittaker
- The Barbara K. Ostrom (1978) Bioinformatics and Computing Facility in the Swanson Biotechnology Center, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Kyle Karhohs
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Aurora A Burds
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Kriti S Subramanyam
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.,David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Anne E Carpenter
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Brian H Eisner
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Cima
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA. .,David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Department of Material Science Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
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Chen YB, Gao L, Jiang Q, Ran K, Luo RT. Tamsulosin Monotherapy Is Effective in Reducing Ureteral Stent-related Symptoms: A Meta-analysis of Randomized Controlled Studies. Curr Med Sci 2019; 39:707-718. [DOI: 10.1007/s11596-019-2096-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/17/2019] [Indexed: 10/25/2022]
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8
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Sali GM, Joshi HB. Ureteric stents: Overview of current clinical applications and economic implications. Int J Urol 2019; 27:7-15. [PMID: 31549458 DOI: 10.1111/iju.14119] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 09/01/2019] [Indexed: 12/16/2022]
Abstract
Ureteric stents are one of the most crucial tools used for various clinical conditions in the urological field. Placement of a ureteric stent, for short- or long-term use, remains one of the commonest urological interventional procedures. In the past few decades, ureteral stents have undergone notable technological advancements. However, an ideal stent without significant side-effects is yet to be engineered. Indwelling ureteric stents are often accompanied by physical distress to the patient and clinical complications, such as bacterial adhesion, encrustation, malpositioning, stent fracture and forgotten stent syndrome, that influence patients' health-related quality of life. In the market, different stent types are available, designed to reduce infections, and improve patient symptoms and tolerance. In this review, we have emphasized the recent developments that have taken place in stent design, size, materials and coating. This overview looks at current practices and problems related to stents, along with clinical and economic considerations. Few trial studies have been enumerated in the context of utilization of a ureteral stent symptom questionnaire and various stent models to compare their effects in patients.
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Milburn PA, Thai KH, El Mekresh A, Lowry PS, El Tayeb MM. Relation of postoperative pain medication to return for unplanned care after ureteroscopy. Proc (Bayl Univ Med Cent) 2019; 32:199-201. [PMID: 31191127 DOI: 10.1080/08998280.2019.1573715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/10/2019] [Accepted: 01/17/2019] [Indexed: 01/24/2023] Open
Abstract
To determine whether the US Drug Enforcement Agency (DEA) class of narcotics prescribed to patients after ureteroscopy impacts their rate of return for unplanned care, a retrospective analysis of patients from February 2014 through March 2016 was performed. Data were collected for the first 90 days after surgery. Patients were divided into groups based on the narcotics schedule prescribed after surgery. Results showed that there was no statistical difference in return for unplanned care when comparing the groups based on their prescribed pain medication. Among the 475 patients, 17% returned to the emergency department after ureteroscopy, 12% contacted the clinic due to discomfort/pain, and 8% were readmitted to the hospital within 90 days of surgery. The data indicated that patients who were not prescribed a narcotic after surgery sought unplanned care at a slightly higher rate than those who were. In conclusion, the US DEA class of narcotics prescribed after ureteroscopy did not have a statistically significant impact on the rate of return for unplanned care. These findings may improve opioid stewardship in patients undergoing outpatient ureteroscopy.
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Affiliation(s)
- Preston A Milburn
- Division of Urology, Department of Surgery, Scott & White Medical Center-TempleTempleTexas
| | - Kim H Thai
- Division of Urology, Department of Surgery, Scott & White Medical Center-TempleTempleTexas
| | - Amr El Mekresh
- Division of Urology, Department of Surgery, Scott & White Medical Center-TempleTempleTexas
| | - Patrick S Lowry
- Division of Urology, Department of Surgery, Scott & White Medical Center-TempleTempleTexas
| | - Marawan M El Tayeb
- Division of Urology, Department of Surgery, Scott & White Medical Center-TempleTempleTexas
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Beysens M, Tailly TO. Ureteral stents in urolithiasis. Asian J Urol 2018; 5:274-286. [PMID: 30364608 PMCID: PMC6197553 DOI: 10.1016/j.ajur.2018.07.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/29/2018] [Accepted: 05/25/2018] [Indexed: 02/08/2023] Open
Abstract
Ever since the ureteral stent design was fitted with a curl on both sides to prevent it from migrating up or down the ureter some 40 years ago, its use has gained tremendous momentum, aiding in the rise and evolution of endourology and has confidently kept its place in modern time urology. Over the past four decades, several designs, coating and biomaterials have been developed, trying to reduce infection, encrustation and other stent related symptoms. As the ideal stent has not yet been discovered, different ways of helping patients with their complaints have been researched. This review will cover these aspects of stent use in urolithiasis.
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Affiliation(s)
| | - Thomas O. Tailly
- Department of Urology, University Hospital Ghent, Ghent, Belgium
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Jian Z, Chen Y, Liu Q, Liao B, Yang T, Li H, Wang K. Combination of solifenacin and tamsulosin may provide additional beneficial effects for ureteral stent-related symptoms—outcomes from a network meta-analysis. World J Urol 2018; 37:289-297. [DOI: 10.1007/s00345-018-2404-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022] Open
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