1
|
Nam KH, Suh J, Shin JH, Chae HK, Park HK. Effect of perioperative tamsulosin on successful ureteral access sheath placement and stent-related symptom relief: A double-blinded, randomized, placebo-controlled study. Investig Clin Urol 2024; 65:342-350. [PMID: 38978214 PMCID: PMC11231658 DOI: 10.4111/icu.20240005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/18/2024] [Accepted: 04/23/2024] [Indexed: 07/10/2024] Open
Abstract
PURPOSE This study investigated the effect of administering tamsulosin before surgery on the successful insertion of a 12/14 French (F) ureteral access sheath (UAS) during the procedure, as well as the impact of preoperative and postoperative tamsulosin use on symptoms related to the ureteral stent. MATERIALS AND METHODS This study was a randomized, single-center, double-blinded, placebo-controlled trial involving 200 patients who underwent unilateral retrograde intrarenal surgery. Patients received either tamsulosin (0.4 mg) or placebo 1 week before surgery until stent removal. Patients were randomly assigned to one of four groups. Group 1 received tamsulosin throughout the study period. Group 2 received tamsulosin before surgery and placebo after surgery. Group 3 received placebo before surgery and tamsulosin after surgery. Group 4 received placebo before and after surgery. The USSQ (Ureteral Stent Symptom Questionnaire) was completed between postoperative days 7 and 14 immediately before stent removal. RESULTS A total of 160 patients were included in this analysis. Their mean age was 55.0±11.0 years, and 48 patients (30.0%) were female. In the group that received preoperative tamsulosin, the success rate of 12/14F UAS deployment was significantly higher than that of the preoperative placebo group (88.0 vs. 75.3%, p=0.038). Preoperative and postoperative tamsulosin did not significantly alleviate symptoms related to the ureteral stent. CONCLUSIONS Our results revealed that preoperative administration of tamsulosin improved the success of larger-sized UAS, whereas preoperative and postoperative tamsulosin use did not significantly alleviate symptoms related to ureteral stents.
Collapse
Affiliation(s)
- Kyeng Hyun Nam
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jungyo Suh
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Hyun Shin
- Department of Urology, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Han Kyu Chae
- Department of Urology, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea
| | - Hyung Keun Park
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| |
Collapse
|
2
|
Efficacy and safety of combination of mirabegron and solifenacin in patients with double-J stent related overactive bladder: a prospective study. Sci Rep 2022; 12:18844. [PMID: 36344629 PMCID: PMC9640653 DOI: 10.1038/s41598-022-23795-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
Abstract
To observe the efficacy and safety of solifenacin and/or mirabegron as a medical expulsive therapy (MET) in patients with double-J stent-related overactive bladder (OAB) symptoms. A total of 219 patients with double-J stent-related OAB symptoms were prospectively randomized into two groups. One-hundred and nine cases in the combination group accepted mirabegron and solifenacin therapy and 110 cases as control only accepted solifenacin therapy. The lower urinary tract symptoms and overactive bladder questionnaire (OAB-q) health-related quality of life (HRQol) and symptom bother score between two groups were compared at the 1st, 2nd and 4th week ends. All of 219 patients were randomly assigned to two groups, of which 109 patients were included in the combination group and 110 in the solifenacin group. The incidences of LUTS, including urgency, frequent urination, and incontinence episodes, in the 2nd week (44.9% vs. 64.5%, P = 0.028; 48.6% vs. 62.7%, P = 0.036; and 40.4% vs. 56.4%, P = 0.018) and the 4th week (14.7% vs. 30.9%, P = 0.004; 16.5% vs. 33.6%, P = 0.003; and 11.9% vs. 26.4%, P = 0.007) after combination treatment were significantly lower than those in the solifenacin group. The incidence of drug-related adverse events in the solifenacin group was higher than that in the combination group, but there was no statistically significant difference (P > 0.05). In terms of secondary variables, the OAB-q HRQol score in the combination group was statistically superior in comparison with that in the solifenacin group between the second and fourth week (77.9 vs. 76.4, P = 0.020; and 87.9 vs. 85.6, P = 0.001). The OAB-q symptom bother score was higher in the solifenacin group than in the combination group (37.6 vs. 36.4, P = 0.016; and 26.2 vs. 24.8, P = 0.003). Combination therapy of solifenacin and mirabegron demonstrated significant improvements over solifenacin monotherapy in reducing OAB symptoms associated with double-J stents, and providing a higher quality of life without increasing bothersome adverse effects.
Collapse
|
3
|
Rove KO, Halstead NV, Wiesen BM, Bielsky AR, Campbell JB. Randomized controlled trial of NSAID prior to cystoscopic ureteral stent removal in a pediatric population. J Pediatr Urol 2022; 18:679.e1-679.e9. [PMID: 35987678 DOI: 10.1016/j.jpurol.2022.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/05/2022] [Accepted: 07/26/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Ureteral spasm, common with ureteral stents, is partially mediated by prostaglandins and may be suppressed by cyclooxygenase inhibitors like non-steroidal anti-inflammatory (NSAIDs). Practices currently vary widely for pain management in patients with ureteral stents, sometimes including opioids. OBJECTIVE We aimed to determine if NSAID given prior to stent removal would reduce postoperative pain. We hypothesized there would be at least a 75% reduction in postoperative severe pain (pain score ≥7) in patients receiving ibuprofen compared to placebo. STUDY DESIGN We performed a double-blind, placebo-controlled randomized controlled trial on pediatric urology patients with an indwelling ureteral stent undergoing removal in the operating room from 2014 to 2019. 20 patients in each arm were needed to achieve 80% power to detect a 75% reduction in the estimated 55% incidence of severe postoperative pain (α = 0.05). Patients ≥4 years old who had a unilateral stent placed after treatment of urolithiasis or ureteropelvic junction obstruction were randomized to NSAID or placebo in a 1:1 ratio at least 15 min prior to scheduled stent removal. Patients estimated pain using Faces Pain Scale-Revised (FPS-R) or visual analogue scale (VAS) prior to and 24 h after stent removal. RESULTS 254 patients undergoing stent removal were assessed for eligibility, and 44 randomized patients were analyzed using intention to treat analysis. The cohorts were demographically similar and received similar anesthesia treatment. There was no significant difference in maximum post anesthesia care unit pain score (p = 0.269) or use of in-hospital opioids (p = 0.626) between the two groups. No difference was seen in the incidence of severe postoperative pain (p = 1.0), thus rejecting the hypothesis. Significant worsened postoperative pain (pain score increases of ≥2 between time points) decreased from 22.7% to 13.6% between placebo and NSAID, but this did not reach significance (p = 0.410). DISCUSSION There was no difference in postoperative pain for patients undergoing ureteral stent removal given preoperative NSAID versus placebo. The incidence of severe pain before and after stent removal was low, ranging from 4.5 to 9.1%. CONCLUSION Research to understand the etiology of pain after stent removal and techniques to minimize or prevent discomfort should continue in order to optimize patient outcomes.
Collapse
Affiliation(s)
- Kyle O Rove
- Department of Pediatric Urology, Children's Hospital Colorado, 13123 E. 16th Ave, B-463, Aurora, CO 80045, USA.
| | - N Valeska Halstead
- Department of Surgery, Division of Urology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Brett M Wiesen
- Department of Surgery, Division of Urology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Alan R Bielsky
- Division of Pediatric Anesthesiology, Department of Anesthesiology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Jeffrey B Campbell
- Pediatric Urology Research Enterprise (PURE), Department of Pediatric Urology, Children's Hospital Colorado, Aurora, CO, USA; Division of Urology, Department of Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, Division of Urology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| |
Collapse
|
4
|
Wu G, Sun F, Sun K, Zhang D, Yao H, Wu J, Cui Y. Impact of differential ureteral stent diameters on clinical outcomes after ureteroscopy intracorporeal lithotripsy: A systematic review and meta-analysis. Int J Urol 2021; 28:992-999. [PMID: 34189773 DOI: 10.1111/iju.14631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/01/2021] [Indexed: 11/28/2022]
Abstract
In this meta-analysis we assessed whether the diameter of ureteral stents (4.7-5-Fr, 6-Fr) has an impact on the rate of occurrence of urinary tract symptoms and complications after successful URS and intracorporeal lithotripsy. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A rigorous search for relevant studies published in MEDLINE, Embase, and the Cochrane Controlled Trials Register was conducted to find informative randomized controlled trials. The reference lists of relevant articles were also manually searched and reviewed. The protocol was prospectively registered at PROSPERO (CRD42020202164). All statistical evaluations were performed using RevMan software version 5.3.0. Seven articles comprising 547 patients were included in the meta-analysis. After placement of ureteral stents with different diameters for approximately 1 week, we found that ureteral stents with smaller diameters (4.7-5-Fr) were associated with significant improvements in the main domain scores on the Ureteral Stent Symptom Questionnaire, such as urinary symptoms (mean difference -4.47, 95% confidence interval -5.87 to -3.08; P < 0.00001) and body pain (mean difference -2.48, 95% confidence interval -4.37 to -0.59; P = 0.01), but poor outcomes in stent migration compared to ureteral stents with a 6-Fr diameter (odds ratio 3.00, 95% confidence interval 1.06-8.51; P = 0.04). However, there were no significant differences in Ureteral Stent Symptom Questionnaire scores with regard to work performance (mean difference -0.56, 95% confidence interval -2.52 to 1.40; P = 0.58), general health (mean difference -2.29, 95% confidence interval -4.95 to 0.37; P = 0.09), additional problems (mean difference -0.43, 95% confidence interval -1.02 to 0.15; P = 0.15), and complications such as fever (odds ratio 0.75, 95% confidence interval 0.24-2.39; P = 0.63). Ureteral stents with a diameter of 4.7-5-Fr have better outcomes than those with a diameter of 6-Fr, based on the Ureteral Stent Symptom Questionnaire pain and urinary tract symptoms scores. However, they are more prone to migration compared to those with a larger diameter.
Collapse
Affiliation(s)
- Gang Wu
- Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Fengze Sun
- Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Kai Sun
- Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Dongxu Zhang
- Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Huibao Yao
- Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Jitao Wu
- Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Yuanshan Cui
- Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.,Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Moataz A, Gallouo M, Mawuko-Gadosseh Y, Graiouid M, Bai W, Dakir M, Debbagh A, Aboutaieb R. [Evaluation of the tolerance of the ureteral catheter JJ by the use of the USSQ self-questionnaire]. Prog Urol 2020; 31:85-90. [PMID: 33183917 DOI: 10.1016/j.purol.2020.05.012] [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: 07/24/2019] [Revised: 02/14/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Evaluation of the quality of life patients with a ureteral catheter JJ (US). METHOD This study was conducted from 01/2016 to 15/02/2017, including all patients operated on a rise of US. The USSQ questionnaire (Ureteral Stent Symptom Questionnaire) validated in French in 2010 was filled during the perioperative period with SU in place (S1), 4 weeks after putting the US (S2) and 4 weeks after removal of the US (S3), it is grouped into 6 sections: urinary symptoms, body pain, general condition, professional impact, sexuality, other problems. The Wilcoxon test was used to compare the statistical averages. RESULTS We identified 150 patients including 89 women (59.3%) and 61 men (40.7%). The average age of our patients is 49.5 years. The quality of life appeared to be significantly altered in all areas explored by the questionnaire: urinary symptoms had a mean score one week after the US rise (S1) was 29.5 versus 25.3 at four weeks after ablation (S3) of US at P<0.0001), pain persisted at four weeks after US ablation at an average S3 score of 10.6 versus 14.5 at S1 at P=0.003. The patients' EG was also altered after the placement of the SU: S1 of 16.6 versus S2 18.5 (P<0.0001), the presence of a US did not have a great impact on the activity professional active patients: active (S1 of 14.9 versus S3 of 13.3 P=0.6). But it was a sexual disability of the sexuality carrier: average score of 5.3 in S1 vs. 5.2 in S3 for a value=0.122. There is no significant difference if the US is raised urgently or in a scheduled manner. CONCLUSION US appears to have a significant impact on the quality of life of patients. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- A Moataz
- CHU Ibn Rochd de Casablanca, service d'urologie, faculté de médecine et de pharmacie de Casablanca, 19, Tarik ibnou quartiers des hôpitaux, Casablanca, Maroc
| | - M Gallouo
- CHU Ibn Rochd de Casablanca, service d'urologie, faculté de médecine et de pharmacie de Casablanca, 19, Tarik ibnou quartiers des hôpitaux, Casablanca, Maroc.
| | - Y Mawuko-Gadosseh
- CHU Ibn Rochd de Casablanca, service d'urologie, faculté de médecine et de pharmacie de Casablanca, 19, Tarik ibnou quartiers des hôpitaux, Casablanca, Maroc
| | - M Graiouid
- CHU Ibn Rochd de Casablanca, service d'urologie, faculté de médecine et de pharmacie de Casablanca, 19, Tarik ibnou quartiers des hôpitaux, Casablanca, Maroc
| | - W Bai
- CHU Ibn Rochd de Casablanca, service d'urologie, faculté de médecine et de pharmacie de Casablanca, 19, Tarik ibnou quartiers des hôpitaux, Casablanca, Maroc
| | - M Dakir
- CHU Ibn Rochd de Casablanca, service d'urologie, faculté de médecine et de pharmacie de Casablanca, 19, Tarik ibnou quartiers des hôpitaux, Casablanca, Maroc
| | - A Debbagh
- CHU Ibn Rochd de Casablanca, service d'urologie, faculté de médecine et de pharmacie de Casablanca, 19, Tarik ibnou quartiers des hôpitaux, Casablanca, Maroc
| | - R Aboutaieb
- CHU Ibn Rochd de Casablanca, service d'urologie, faculté de médecine et de pharmacie de Casablanca, 19, Tarik ibnou quartiers des hôpitaux, Casablanca, Maroc
| |
Collapse
|
7
|
Lorange M, Monnet E. Postoperative outcomes of 12 cats with ureteral obstruction treated with ureteroneocystostomy. Vet Surg 2020; 49:1418-1427. [PMID: 32735031 DOI: 10.1111/vsu.13488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 09/21/2019] [Accepted: 10/18/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report complications and long-term outcomes of cats with benign ureteral obstruction treated with ureteroneocystostomy and to determine the effects of double pigtail catheter (DPT) placement on postoperative outcomes. STUDY DESIGN Retrospective study. ANIMALS Twelve client-owned cats with ureteral urolithiasis treated with ureteroneocystostomy. METHODS Records were reviewed for signalment, location of the obstruction, diagnostic tests, surgical technique, perioperative complications, long-term measurements of kidney function, and survival. Cats were divided into two groups; in one group, a DPT was placed at the time of ureteroneocystostomy, and, in the other group, a DPT was not placed at the time of ureteroneocystostomy (NDPT). RESULTS A DPT was placed in six of 12 cats. The NDPT group included four cats with temporary catheters and two cats with no catheter. Median creatinine concentration decreased from 10.4 mg/dL (range, 1.6-20.3) to 2.2 mg/dL (range, 1.1-3.6) at the time of discharge (P = .015) in all cats. Two cats in the NDPT group required revision surgery for uroabdomen. Eleven cats were discharged from the hospital. Long-term complications (hematuria, pollakiuria, urinary tract infections) were more common in the DPT group (P = .047). Seven cats were alive a median of 329 days (range, 8-1772) after surgery. Median creatinine concentration was 2.0 mg/dL (range, 0.6-6.4) at a median of 157 days (range, 43-1772) after surgery. CONCLUSION Ureteroneocystostomy resulted in acceptable long-term outcomes in 11 of 12 cats. The placement of a DPT did not influence the long-term outcome in this small population. CLINICAL SIGNIFICANCE Ureteroneocystostomy with or without intraoperative placement of a DPT should be considered to relieve benign ureteral obstructions in cats.
Collapse
Affiliation(s)
- Maxime Lorange
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Eric Monnet
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| |
Collapse
|
8
|
Leong JY, Steward JE, Healy KA, Hubosky SG, Bagley DH. Indwelling ureteric stents: Patterns of use and nomenclature. Arab J Urol 2020; 18:241-246. [PMID: 33312735 PMCID: PMC7717614 DOI: 10.1080/2090598x.2020.1761675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objectives: To evaluate ureteric stenting practice patterns amongst a range of academic and community urologists, and to examine the nomenclature used to identify an indwelling ureteric stent from both our questionnaire and from a review of the literature. Subjects and methods: A 16-question, peer-reviewed online survey was distributed to members of the Mid-Atlantic American Urological Association. Responses were collected over a 1-month period. Questions included demographics, ureteric stenting practice patterns, and utilization of stenting nomenclature. Inappropriate use of nomenclature was defined as a mismatch between the visually depicted stents and the written description amongst urologists. Trends in ureteric stenting and nomenclature usage were tabulated and analyzed. Results: Of 863 members, 105 (12.2%) responded to the survey. There was a wide variety of practice settings, with the single-specialty group (44.2%) and academic/university (27.9%) being the two most common. Most providers used both cystoscopy and fluoroscopy to place stents (87.5%) as compared to fluoroscopy alone (12.5%). Most urologists (63.5%) removed stents with cystoscopy as compared to using a stent string (36.5%). While about half (51.0%) of the respondents left stents in situ for ≤3 months, many respondents (43.3%) felt comfortable with maximum dwell times of up to 6 months. The most commonly placed stent was the double pigtail stent (80.8%). However, most respondents inappropriately described this stent design as a Double J stent (72.1%). In the recent literature, 80% of articles clearly defined as using double pigtail stents, incorrectly identified their stent as a ‘Double J’. Conclusions: Variations in ureteric stenting practice patterns exist amongst community and academic urologists. Although most urologists utilize double pigtail ureteric stents, the majority inaccurately identified this stent design as a Double J. We propose use of the term ‘indwelling ureteric stent’ (IUS) unless describing any specific stent design.
Collapse
Affiliation(s)
- Joon Yau Leong
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
| | - James E Steward
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kelly A Healy
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Scott G Hubosky
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Demetrius H Bagley
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
| |
Collapse
|
9
|
Efficacy of Tadalafil on Ureteral Stent Symptoms: A Randomized Controlled Trial. Nephrourol Mon 2019. [DOI: 10.5812/numonthly.85523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
10
|
Du K, Wang RS, Vetter J, Paradis AG, Figenshau RS, Venkatesh R, Desai AC. Unplanned 30-Day Encounters After Ureterorenoscopy for Urolithiasis. J Endourol 2018; 32:1100-1107. [PMID: 30156428 DOI: 10.1089/end.2018.0177] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To identify avoidable predictors of postureteroscopy (URS) unplanned encounters and to minimize 30-day encounters. MATERIALS AND METHODS We performed retrospective chart review and telephone surveys on patients who underwent URS for urolithiasis between January and June 2016. Univariate and multivariable analyses evaluated for potential predictors of unplanned encounters. RESULTS Of 157 patients, there were 44 (28.0%) unplanned patient-initiated clinical phone calls, 23 (14.6%) emergency department (ED) visits, and 8 (5.1%) readmissions, with pain being the most common complaint during the encounters. Factors associated with a higher rate of phone calls include first-time stone procedure (36.6% vs 20.9%, p = 0.029), outpatient status (30.3% vs 0%, p = 0.021), intraoperative stent placement (31.2% vs 0%, p = 0.006), and stent removal at home (58.8% vs 28.8%, p = 0.014). Factors associated with increased rate of ED visits were first-time stone procedure (22.5% vs 8.1%, p = 0.011) and ureteral access sheath (UAS) usage (29.6% vs 11.8%, p = 0.018). Factors associated with a higher rate of readmissions were lower body mass index (23.9 vs 29.7, p = 0.013), bilateral procedure (20.0% vs 2.9%, p = 0.010), and UAS usage (14.8% vs 3.1%, p = 0.032). Stone burden, operative time, Charlson comorbidity index, and preoperative urinary tract infection were not significantly associated with postoperative encounters. CONCLUSIONS Pain, first-time stone treatment, presence of a ureteral stent, outpatient status, bilateral procedures, and UAS usage were common reasons for postoperative encounters after URS. Appropriate perioperative patient education and counseling and adequate pain management may minimize these encounters and improve treatment quality and patient satisfaction.
Collapse
Affiliation(s)
- Kefu Du
- 1 Division of Urologic Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - Robert S Wang
- 2 Division of Urology, University of Michigan Medical School , Ann Arbor, Michigan
| | - Joel Vetter
- 1 Division of Urologic Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - Alethea G Paradis
- 1 Division of Urologic Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - Robert S Figenshau
- 1 Division of Urologic Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - Ramakrishna Venkatesh
- 1 Division of Urologic Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - Alana C Desai
- 1 Division of Urologic Surgery, Washington University School of Medicine , St. Louis, Missouri
| |
Collapse
|
11
|
Jo JK, Kim JH, Kim KS, Chung JH, Kim YT, Choi HY, Song ES, Lee B, Lee SW. Effect of highly concentrated hyaluronic acid/chondroitin sulphate instillation on ureteric stent-induced discomfort after ureteroscopic lithotripsy: a multicentre randomised controlled pilot study. BJU Int 2018; 122:858-865. [DOI: 10.1111/bju.14392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jung Ki Jo
- Department of Urology; Hanyang University Seoul Hospital; Seoul Korea
| | - Jae Heon Kim
- Department of Urology; Soonchunhyang University Hospital; Soonchunhyang University Medical College; Seoul Korea
| | - Kyu Shik Kim
- Department of Urology; Hanyang University Guri Hospital; Guri Korea
| | - Jae Hoon Chung
- Department of Urology; Hanyang University Seoul Hospital; Seoul Korea
| | - Yong Tae Kim
- Department of Urology; Hanyang University Seoul Hospital; Seoul Korea
| | - Hong Yong Choi
- Department of Urology; Hanyang University Guri Hospital; Guri Korea
| | - Eun-Seop Song
- Department of Obstetrics and Gynecology; Inha University School of Medicine; Incheon Korea
| | - Bora Lee
- Department of Biostatistics; Clinical Trial Center; Soonchunhyang University Bucheon Hospital; Bucheon Korea
| | - Seung Wook Lee
- Department of Urology; Hanyang University Guri Hospital; Guri Korea
| |
Collapse
|
12
|
Re: Efficacy of Tamsulosin, Oxybutynin, and Their Combination in the Control of Double-J Stent-Related Lower Urinary Tract Symptoms. J Urol 2018; 199:326. [DOI: 10.1016/j.juro.2017.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 11/19/2022]
|
13
|
Zhang L, Li J, Pan M, Han W, Liu S, Xiao Y. Doxazosin oral intake therapy to relieve stent - related urinary symptoms and pain: a prospective, randomized, controlled study. Int Braz J Urol 2017; 42:727-33. [PMID: 27564283 PMCID: PMC5006768 DOI: 10.1590/s1677-5538.ibju.2015.0570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 12/16/2015] [Indexed: 11/22/2022] Open
Abstract
Objective: To assess the impact of Doxazosin Oral Intake Therapy on urinary symptoms and pain in patients with indwelling ureteral stents Patients and Methods: A total of 239 patients with ureteral stone-related hydronephrosis who underwent a double-J stent insertion after ureteroscopic lithotripsy were enrolled. Patients were randomized to receive doxazosin cotrolled release 4 mg once daily for 4 weeks or matching placebo. Patients completed the brief-form Chinese version Ureteric Stent Symptom Questionnaire (USSQ) and quality of life (QoL) score 2 weeks and 4 weeks after stent placement and 4 weeks after stent withdrawal. The analgesic use was also recorded during the stenting period. Results: Patients in Doxazosin Oral Intake Therapy group, in the first 2 weeks and second 2 weeks with the stent in situ, expressed significant lower daytime frequency (p=0.028 and p=0.038), nocturia (p=0.021 and p=0.008) and urgency (p=0.012 and p=0.014), respectively. Similarly, flank pain score, QoL score and analgesic use were also significant less in the stenting period. There was no significant difference in scores of urinary symptoms, pain and QoL during the post-stent period between two cohorts. Conclusions: Doxazosin Oral Intake Therapy reduced stent-related urinary symptoms, pain and the negative impact on QoL.
Collapse
Affiliation(s)
- Long Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Junping Li
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Department of Urology, Jingmen No.1 People's Hospital, Jingmen, Hubei, China
| | - Minjie Pan
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Department of Urology, Changzhou No.2 People's Hospital, Changzhou, Jiangsu, China
| | - Weiwei Han
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shucheng Liu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yajun Xiao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
14
|
Maldonado-Avila M, Garduno-Arteaga L, Jungfermann-Guzman R, Manzanilla-Garcia HA, Rosas-Nava E, Procuna-Hernandez N, Vela-Mollinedo A, Almazan-Trevino L, Guzman-Esquivel J. Efficacy of Tamsulosin, Oxybutynin, and their combination in the control of double-j stent-related lower urinary tract symptoms. Int Braz J Urol 2017; 42:487-93. [PMID: 27286111 PMCID: PMC4920565 DOI: 10.1590/s1677-5538.ibju.2015.0186] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 08/11/2015] [Indexed: 11/22/2022] Open
Abstract
Introduction and objective Indwelling double J ureteral stents are used routinely in the resolution of ureteral obstruction caused by different etiologies. Evaluation of urinary symptoms related to double-J stent, indicate that these affect 73-90% of patients. We conducted a prospective, randomized study, to evaluate the efficacy of tamsulosin, oxybutinin and combination therapy in improving the urinary symptoms. Methods Patients who underwent ureteral stent placement after ureterolithotripsy (total 51), were randomized into three groups: Group I: Tamsulosin 0.4 mg. once per day(17 patients), Group II: Oxybutinin 5 mg. once per day (17 patients), Group III: Tamsulosin+ oxybutynin once per day (17 patients). All the groups received the drugs for three weeks and completed a Spanish validated Ureteral Stent Symptom Questionnaire (USSQ) at day 7 and 21. Results Repeated measures ANOVA showed mean urinary symptom index score was 22.3 vs. 15.5 in group three (p<0.001) at day 7 and 21 respectively. The mean work performance index was 6.6 vs 8.1 (p=0.049) favoring tamsulosin group, the mean sexual score was 0.5 vs 1.5 (p=0.03). Among additional problems the mean was 7.2 vs 6.2 (p=0.03). No significant difference was noted among pain and general health index. No side effects were reported. Conclusions Combination therapy with tamsulosin and oxybutynin improved irritative symptoms and work performance as well as sexual matters. Combination therapy should be considered for patients who complained of stent related symptoms.
Collapse
|
15
|
Effects of naftopidil on double-J stent-related discomfort: a multicenter, randomized, double-blinded, placebo-controlled study. Sci Rep 2017. [PMID: 28646216 PMCID: PMC5482907 DOI: 10.1038/s41598-017-04505-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
To evaluate the effect of naftopidil 75 mg once daily for ureteral double-J (DJ) stent-related discomfort after a ureteroscopic procedure using a multicenter, randomized, double-blinded, placebo-controlled study. 100 patients with indwelled retrograde DJ ureteral stents after ureteroscopic stone removal or retrograde intrarenal surgery (RIRS) were randomized 1:1 to receive either placebo or naftopidil during the stenting period. At the time of stent removal, the Ureteral Stent Symptom Questionnaire (USSQ), the International Prostate Symptom Score and the total amount of used analgesics were reported. Of the 92 patients who completed the study, 49 patients were enrolled in the placebo group, and 43 patients in the naftopidil group. USSQ urinary symptom scores (30.90 vs. 29.23, p = 0.299) and USSQ body pain scores (22.28 vs. 19.58, respectively, p = 0.286) were lower in the naftopidil group than in the placebo group, but the difference was not significant. Multivariate analysis showed that the use of a ureteral access sheath during RIRS was the only significant predictor of postoperative DJ-related pain (OR = 2.736, p = 0.031). The use of naftopidil once daily did not significantly reduce DJ ureteral stent-related discomfort. Larger-scaled prospective studies should be conducted to evaluate the effects of naftopidil on DJ stent-related symptoms and surgeries.
Collapse
|
16
|
The role of solifenacin, as monotherapy or combination with tamsulosin in ureteral stent-related symptoms: a systematic review and meta-analysis. World J Urol 2017; 35:1669-1680. [DOI: 10.1007/s00345-017-2051-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/18/2017] [Indexed: 01/08/2023] Open
|
17
|
Ragab M, Soliman MG, Tawfik A, Abdel Raheem A, El-Tatawy H, Abo Farha M, Magdy M, Elashry O. The role of pregabalin in relieving ureteral stent-related symptoms: a randomized controlled clinical trial. Int Urol Nephrol 2017; 49:961-966. [DOI: 10.1007/s11255-017-1561-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 02/25/2017] [Indexed: 11/29/2022]
|
18
|
Abdelkader O, Mohyelden K, Sherif M, Metwaly A, Aldaqadossi H, Shelbaya A, Khairy H, Elnashar A. Impact of Tamsulosin, Tolterodine and drug-combination on the outcomes of lower urinary tract symptoms secondary to post-ureteroscopy ureteral stent: A prospective randomized controlled clinical study. AFRICAN JOURNAL OF UROLOGY 2017. [DOI: 10.1016/j.afju.2016.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
19
|
Dellis AE, Papatsoris AG, Keeley FX, Bamias A, Deliveliotis C, Skolarikos AA. Tamsulosin, Solifenacin, and Their Combination for the Treatment of Stent-Related Symptoms: A Randomized Controlled Study. J Endourol 2017; 31:100-109. [DOI: 10.1089/end.2016.0663] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Athanasios E. Dellis
- Second Department of Surgery, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, Maroussi, Greece
| | - Athanasios G. Papatsoris
- Second Department of Urology, School of Medicine, Sismanogleion Hospital, National and Kapodistrian University of Athens, Maroussi, Greece
| | - Francis X. Keeley
- Southmead Hospital, Bristol Urological Institute, Bristol, United Kingdom
| | - Aristotelis Bamias
- Department of Therapeutics, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalambos Deliveliotis
- Second Department of Urology, School of Medicine, Sismanogleion Hospital, National and Kapodistrian University of Athens, Maroussi, Greece
| | - Andreas A. Skolarikos
- Second Department of Urology, School of Medicine, Sismanogleion Hospital, National and Kapodistrian University of Athens, Maroussi, Greece
| |
Collapse
|
20
|
Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, Pace KT, Pais VM, Pearle MS, Preminger GM, Razvi H, Shah O, Matlaga BR. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol 2016; 196:1161-9. [PMID: 27238615 DOI: 10.1016/j.juro.2016.05.091] [Citation(s) in RCA: 356] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE This Guideline is intended to provide a clinical framework for the surgical management of patients with kidney and/or ureteral stones. The summary presented herein represents Part II of the two-part series dedicated to Surgical Management of Stones: American Urological Association/Endourological Society Guideline. Please refer to Part I for introductory information and a discussion of pre-operative imaging and special cases. MATERIALS AND METHODS A systematic review of the literature (search dates 1/1/1985 to 5/31/2015) was conducted to identify peer-reviewed studies relevant to the surgical management of stones. The review yielded an evidence base of 1,911 articles after application of inclusion/exclusion criteria. These publications were used to create the Guideline statements. Evidence-based statements of Strong, Moderate, or Conditional Recommendation were developed based on benefits and risks/burdens to patients. Additional directives are provided as Clinical Principles and Expert Opinions when insufficient evidence existed. RESULTS The Panel identified 12 adult Index Patients to represent the most common cases seen in clinical practice. Three additional Index Patients were also created to describe the more commonly encountered special cases, including pediatric and pregnant patients. With these patients in mind, Guideline statements were developed to aid the clinician in identifying optimal management. CONCLUSIONS Proper treatment selection, which is directed by patient- and stone-specific factors, remains the greatest predictor of successful treatment outcomes. This Guideline is intended for use in conjunction with the individual patient's treatment goals. In all cases, patient preferences and personal goals should be considered when choosing a management strategy.
Collapse
Affiliation(s)
- Dean Assimos
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Amy Krambeck
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Nicole L Miller
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Manoj Monga
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - M Hassan Murad
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Caleb P Nelson
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Kenneth T Pace
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Vernon M Pais
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Margaret S Pearle
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Glenn M Preminger
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Hassan Razvi
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Ojas Shah
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Brian R Matlaga
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| |
Collapse
|
21
|
Park A, Venkatesh R. Understanding the Ureter: Challenges and Opportunities. J Endourol 2016; 30 Suppl 1:S34-6. [DOI: 10.1089/end.2016.0063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alyssa Park
- Division of Urology, Washington University School of Medicine, Saint Louis, Missouri
| | - Ramakrishna Venkatesh
- Division of Urology, Washington University School of Medicine, Saint Louis, Missouri
| |
Collapse
|
22
|
Abdelaal AM, Al-Adl AM, Abdelbaki SA, Al Azab MM, Al Gamal KA. Efficacy and safety of tamsulosin oral-controlled absorption system, solifenacin, and combined therapy for the management of ureteric stent-related symptoms. Arab J Urol 2016; 14:115-22. [PMID: 27489738 PMCID: PMC4963155 DOI: 10.1016/j.aju.2016.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 12/28/2015] [Accepted: 01/12/2016] [Indexed: 12/04/2022] Open
Abstract
Objectives To evaluate the efficacy of solifenacin, tamsulosin oral-controlled absorption system (OCAS), and the combination of both drugs on JJ stent-related symptoms using the validated Arabic version of the ureteric stent symptom questionnaire (USSQ). Patients and methods In all, 260 patients who had undergone JJ stenting of the ureter for different endoscopic urological procedures were postoperatively randomly assigned into four equal groups. Patients in Group I received no treatment and served as the control group, Group II patients received tamsulosin OCAS 0.4 mg daily, Group III patients received solifenacin 5 mg daily, and Group IV patients received a combination of both drugs. Before stent removal, all patients completed the Arabic version of the USSQ. Results In all, 234 patients completed the study, comprised of 56 in Group I, 59 in Group II, 58 in Group III, and 61 in Group IV. Baseline characteristics and indications for JJ stenting were comparable in the four groups. There were highly significant differences in all items of the USSQ between the treatment groups and the controls, while Group II and III were comparable. The USSQ score was significantly lower in Group IV vs Groups II and III. Crossing of the distal curl of the stent to the midline had a significant positive correlation with the severity of the urinary symptoms, body pain, general health, and work performance in the medicated groups. Conclusions Combined therapy with tamsulosin OCAS 0.4 mg daily and solifenacin 5 mg daily is a safe and well-tolerated management for stent-related symptoms. However, stent position remains a significant factor affecting response to medical therapy and patients’ health-related quality of life.
Collapse
Affiliation(s)
| | - Ahmed M Al-Adl
- Department of Urology, Benha University, Benha, Egypt; Al Adwani General Hospital, Taif, Saudi Arabia
| | | | - Mohamed M Al Azab
- Department of Urology, Benha University, Benha, Egypt; International Medical Center, Jeddah, Saudi Arabia
| | | |
Collapse
|
23
|
Sivalingam S, Streeper NM, Sehgal PD, Sninsky BC, Best SL, Nakada SY. Does Combination Therapy with Tamsulosin and Tolterodine Improve Ureteral Stent Discomfort Compared with Tamsulosin Alone? A Double-Blind, Randomized, Controlled Trial. J Urol 2016; 195:385-90. [DOI: 10.1016/j.juro.2015.08.104] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Sri Sivalingam
- Endourology and Minimally Invasive Surgery, Glickman Urological and Kidney Institute, Department of Urology, Cleveland Clinic, Cleveland, Ohio
| | - Necole M. Streeper
- Department of Urology, University of Pennsylvania Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Priyanka D. Sehgal
- Department of Urology, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Brian C. Sninsky
- Department of Urology, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Sara L. Best
- Department of Urology, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Stephen Y. Nakada
- Department of Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| |
Collapse
|
24
|
Zhang P, Hu WL, Cheng B, Cheng L, Zeng YJ, Wang G. α 1-blockers for the reduction of ureteric stent-related symptoms: A systematic review and meta-analysis. Exp Ther Med 2015; 11:660-668. [PMID: 26893663 DOI: 10.3892/etm.2015.2942] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 10/21/2015] [Indexed: 11/06/2022] Open
Abstract
The present meta-analysis aimed to evaluate the current evidence for the use of α1-blockers in relieving ureteric stent-related symptoms (USS). Electronic databases, including PubMed, Embase and Cochrane Library, were searched and two independent reviewers identified relevant parallel randomized controlled trials (RCTs), assessed trial quality and extracted data. Review Manager (version 5.2) was used to conduct a meta-analysis of the data. Significant advantages were demonstrated in the treatment group based on International Prostate Symptom Score (IPSS), voiding symptom sub-scores [mean difference (MD), -2.66; 95% confidence interval (CI), (-4.36, -0.96)], Ureteral Stent Symptom Questionnaire (USSQ) urinary symptoms score (MD, -5.84; 95%CI, -9.35 to -2.33), IPSS quality of life score (MD, -1.46; 95%CI, -2.64 to -0.28) USSQ quality of life score (MD, -0.69; 95%CI, -1.10 to -0.28), USSQ pain score (MD, -3.97; 95%CI, -5.52 to -2.42), Visual Analog Pain Scale (MD, -1.53; 95%CI, -2.25 to -0.80) and USSQ general health score (MD, -1.82; 95%CI, -2.47 to -1.18). No significant differences were detected from the following results: IPSS storage symptom sub-score (MD, -0.93; 95%CI, -2.28 to 0.43), USSQ sexual matters score (MD, -0.10; 95%CI, -0.79 to 0.59), USSQ work performance score (MD, 1.64; 95%CI, -2.18 to 5.47) and USSQ additional problems score (MD, -2.02; 95%CI, -4.55 to 0.52). However, significant between-trial heterogeneity was detected following statistical analysis and there were insufficient data to trace its source. The existing RCT data supported the hypothesis that α1-blockers beneficially influence pain, urinary symptoms and the quality of life of patients with an indwelling ureteral stent.
Collapse
Affiliation(s)
- Peng Zhang
- Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Wan-Li Hu
- Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Bei Cheng
- Department of Anatomy and Embryology, School of Basic Medical Sciences, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Long Cheng
- Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Yang-Jun Zeng
- Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Gang Wang
- Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| |
Collapse
|
25
|
A Randomized Controlled Trial to Compare the Safety and Efficacy of Tadalafil and Tamsulosin in Relieving Double J Stent Related Symptoms. Adv Urol 2015; 2015:592175. [PMID: 26788054 PMCID: PMC4691600 DOI: 10.1155/2015/592175] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/17/2015] [Accepted: 11/25/2015] [Indexed: 11/18/2022] Open
Abstract
Objectives. To evaluate the safety and efficacy of Tadalafil and Tamsulosin in treating Double J stent related symptoms. Methods. In a prospective study, 161 patients with DJ related symptoms were randomized into 3 groups: Group A patients (54), Group B patients (53), and Group C patients (54). They were given Tadalafil, Tamsulosin, and placebo, respectively, at 1st week till removal of DJ stent at 3rd week. All patients completed Ureteral Stent Symptom Questionnaire (USSQ) at 1st week and at 3rd week. The statistical significant difference among groups was determined by the t-test, Kruskal-Wallis test and multivariate analysis were used to assess association of the variables within the three groups, and the level of significance was set at P < 0.05. Results. Tadalafil and Tamsulosin were comparable in relieving urinary symptoms, general health, and work performance (OR = 0.65, 1.8, and 0.92). But Tadalafil was more effective in relieving body pain, sexual problems, and additional problems than Tamsulosin (OR = 5.95, 19.25, and 2.69) and was statistically significant as P < 0.05. Conclusion. Tadalafil was as effective as Tamsulosin in relieving urinary symptom but more effective in relieving sexual symptoms and body pain.
Collapse
|
26
|
A randomized controlled trial comparing alpha blocker (tamsulosin) and anticholinergic (solifenacin) in treatment of ureteral stent-related symptoms. World J Urol 2015; 34:963-8. [DOI: 10.1007/s00345-015-1704-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 09/30/2015] [Indexed: 10/22/2022] Open
|
27
|
Decreased urinary glycosaminoglycan excretion following alfuzosin treatment on ureteral stent-related symptoms: a prospective, randomized, placebo-controlled study. Urolithiasis 2015; 44:185-90. [DOI: 10.1007/s00240-015-0810-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/25/2015] [Indexed: 10/23/2022]
|
28
|
Kwon JK, Cho KS, Oh CK, Kang DH, Lee H, Ham WS, Choi YD, Lee JY. The beneficial effect of alpha-blockers for ureteral stent-related discomfort: systematic review and network meta-analysis for alfuzosin versus tamsulosin versus placebo. BMC Urol 2015; 15:55. [PMID: 26104313 PMCID: PMC4477492 DOI: 10.1186/s12894-015-0050-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 06/04/2015] [Indexed: 12/31/2022] Open
Abstract
Background This study was carried out a network meta-analysis of evidence from randomized controlled trials (RCTs) to evaluate stent-related discomfort in patients with alfuzosin or tamsulosin versus placebo. Methods Relevant RCTs were identified from electronic databases. The proceedings of appropriate meetings were also searched. Seven articles on the basis of RCTs were included in our meta-analysis. Using pairwise and network meta-analyses, comparisons were made by qualitative and quantitative syntheses. Evaluation was performed with the Ureteric Stent Symptoms Questionnaire to assess the urinary symptom score (USS) and body pain score (BPS). Results One of the seven RCTs was at moderate risk of bias for all quality criteria; two studies had a high risk of bias. In the network meta-analysis, both alfuzosin (mean difference [MD];−4.85, 95 % confidence interval [CI];−8.53–−1.33) and tamsulosin (MD;−8.84, 95 % CI;−13.08–−4.31) showed lower scores compared with placebo; however, the difference in USS for alfuzosin versus tamsulosin was not significant (MD; 3.99, 95 % CI;−1.23–9.04). Alfuzosin (MD;−5.71, 95 % CI;−11.32–−0.52) and tamsulosin (MD;−7.77, 95 % CI;−13.68–−2.14) showed lower scores for BPS compared with placebo; however, the MD between alfuzosin and tamsulosin was not significant (MD; 2.12, 95 % CI;−4.62–8.72). In the rank-probability test, tamsulosin ranked highest for USS and BPS, and alfuzosin was second. Conclusion The alpha-blockers significantly decreased USS and BPS in comparison with placebo. Tamsulosin might be more effective than alfuzosin.
Collapse
Affiliation(s)
- Jong Kyou Kwon
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
| | - Kang Su Cho
- Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
| | - Cheol Kyu Oh
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
| | - Dong Hyuk Kang
- Department of Urology, Yangpyeong Health Center, Yangpyeong, South Korea.
| | - Hyungmin Lee
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, South Korea.
| | - Won Sik Ham
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.
| | - Young Deuk Choi
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.
| |
Collapse
|
29
|
A critical assessment of the effects of tamsulosin and solifenacin as monotherapies and as a combination therapy for the treatment of ureteral stent-related symptoms: a 2 × 2 factorial randomized trial. World J Urol 2015; 33:1833-40. [DOI: 10.1007/s00345-015-1544-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 03/20/2015] [Indexed: 10/23/2022] Open
|
30
|
The Impact of Ureteral Stent Type on Patient Symptoms as Determined by the Ureteral Stent Symptom Questionnaire: A Prospective, Randomized, Controlled Study. J Endourol 2015; 29:367-71. [DOI: 10.1089/end.2014.0294] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
31
|
Zhou L, Cai X, Li H, Wang KJ. Effects of α-Blockers, Antimuscarinics, or Combination Therapy in Relieving Ureteral Stent-Related Symptoms: A Meta-Analysis. J Endourol 2015; 29:650-6. [PMID: 25491604 DOI: 10.1089/end.2014.0715] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE We evaluated the effects of α-blockers, antimuscarinics, or a combination of both in reducing ureteral stent-related symptoms. METHODS The relevant studies were identified by searching MEDLINE, EMBASE and Cochrane Library Database from January 2000 to May 2014. Randomized controlled trials evaluating effects of α-blocker, antimuscarinic, and combination therapy for stent-related symptoms were included. Two reviewers independently screened studies and extracted data. RESULTS A total of 13 articles were identified including 1408 patients. There were statistically significant differences in urinary symptom (-6.37; P<0.0001) and body pain index score (-7.03; P=0.0008) of the Ureteral Stent Symptom Questionnaire (USSQ), total International Prostate Symptom Score (IPSS) (-4.16; P=0.0006), Visual Analogue Pain Scale (VAPS) score (-2.48; P<0.00001), and quality of life (QoL) (-1.42; P=0.0009) in favor of the α-blocker group. Antimuscarinics alone vs the control group showed significant improvement in total IPSS (mean difference [MD]: -3.76; 95% confidence interval [CI], -5.08 to -2.43; P<0.00001) and QoL (MD: -0.82; 95% CI, -1.31 to -0.32; P=0.001). Compared with α-blockers monotherapy, combination therapy has significant lower total IPSS (MD: -3.74; 95% CI, -4.94 to -2.54; P<0.00001), VAPS (MD: -0.50; 95% CI, -0.89 to -0.11; P=0.01), and QoL (MD: -0.93; 95% CI, -1.30 to -0.55; P<0.00001). CONCLUSIONS Our data showed the beneficial effect of α-blockers alone and antimuscarinics alone in reducing stent-related symptoms. Furthermore, we suggested significant advantages of combination therapy of α-blocker and antimuscarinic compared with α-blocker monotherapy. However, more high quality, randomized controlled trials are warranted to better address this issue, however.
Collapse
Affiliation(s)
- Liang Zhou
- Department of Urology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Xiang Cai
- Department of Urology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Hong Li
- Department of Urology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Kun-Jie Wang
- Department of Urology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| |
Collapse
|
32
|
El-Nahas AR, Elsaadany MM, Tharwat M, Mosbah A, Metwally AH, Hawary A, Keeley FX, Sheir KZ. Validation of the Arabic linguistic version of the Ureteral Stent Symptoms Questionnaire. Arab J Urol 2014; 12:290-3. [PMID: 26019964 PMCID: PMC4434880 DOI: 10.1016/j.aju.2014.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 08/06/2014] [Accepted: 08/09/2014] [Indexed: 12/02/2022] Open
Abstract
Objective To validate the Arabic version of the Ureteral Stent Symptoms Questionnaire (USSQ). Patients and methods The English version of the USSQ was translated into Arabic using a multi-step process by three urologists and two independent translators. The Arabic version was validated by asking 37 patients with temporary unilateral ureteric stents to complete the questionnaire at 2 weeks after stent insertion. The second group included 53 healthy individuals who agreed to complete the Arabic version of the questionnaire. The reliability of the Arabic version was evaluated for internal consistency using Cronbach’s α test. Domain structures were examined by interdomain (section) associations using Spearman’s correlation coefficient (r). The discrimination validity was evaluated by comparing the scores of patients with those of healthy individuals, using the Mann–Whitney test. Results Internal consistency was high for the sexual index and intermediate for urinary, pain and general health indices. There were good correlations of urinary symptoms with body pain (r = 0.596) and general health (r = 0.690). There was also a good correlation between body pain and general health (r = 0.681). For discrimination validity, there were significant changes in all domain scores when comparing patients with ureteric stents and healthy individuals (P < 0.001). Conclusion The Arabic version of the USSQ is a reliable and valid instrument that can be used to evaluate symptoms and health-related quality of life in Arabic patients with ureteric stents.
Collapse
Affiliation(s)
- Ahmed R El-Nahas
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Mohamed M Elsaadany
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Mohamed Tharwat
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed Mosbah
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Amr H Metwally
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Amr Hawary
- Urology Department, Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Francis X Keeley
- Urology Department, Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Khaled Z Sheir
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| |
Collapse
|
33
|
Efficacy of tamsulosin hydrochloride in relieving “double-J ureteral stent-related morbidity”: a randomized placebo controlled clinical study. Int Urol Nephrol 2014; 46:2279-83. [DOI: 10.1007/s11255-014-0825-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 08/21/2014] [Indexed: 10/24/2022]
|
34
|
Kyriazis I, Kallidonis P, Georgiopoulos I, Al-Aown A, Sakellaropoulos G, Stolzenburg JU, Liatsikos E. In vitro Evaluation of Ureteral Contractility: A Comparative Assessment of Human, Porcine and Sheep Ureteral Response to Vardenafil. Urol Int 2014; 94:234-9. [DOI: 10.1159/000358601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 01/14/2014] [Indexed: 11/19/2022]
Abstract
Objectives: Basic science studies of ureteral physiology and pathophysiology are commonly performed on animal ureters due to several limitations associated with human ureteral sampling. In this work we question whether animal ureters are good replicas of human ureteral behavior for pharmacological studies. Materials and Methods: Ureteral rings from human, porcine and ovine ureters underwent the same organ bath protocol. After stimulation with KCl, ureters were subjected to different doses of vardenafil. Basic contractility and ureteral response to vardenafil were analyzed. Results: A different pattern of basic contractility was evidenced between species. Vardenafil administration induced a dose-dependent reduction in KCl-induced amplitude increase in human ureters and a dose-dependent reduction in autonomic contractile rhythm of porcine and ovine ureters. Although animal ureters could predict the relaxant response of human samples to vardenafil, its effect would have been overestimated using only animal models. Conclusions: Human ureteral investigations cannot entirely be replaced by existing animal models since results of the latter will vary significantly according to the tested pharmaceutical agent.
Collapse
|
35
|
Tehranchi A, Rezaei Y, Khalkhali H, Rezaei M. Effects of terazosin and tolterodine on ureteral stent related symptoms: a double-blind placebo-controlled randomized clinical trial. Int Braz J Urol 2014; 39:832-40. [PMID: 24456787 DOI: 10.1590/s1677-5538.ibju.2013.06.09] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 08/15/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the effects of terazosin and tolterodine on ureteral stent discomfort. MATERIALS AND METHODS Of 163 patients assessed for eligibility, 104 patients were randomly assigned to receive placebo, 2 mg of terazosin twice daily, 2 mg of tolterodine daily, or both terazosin plus tolterodine during the stenting period. Prior to stenting and at stent removal, the International Prostate Symptom Score (IPSS), the IPSS quality of life (QoL) subscore and the Visual Analog Scale for Pain were determined. The patients also reported their analgesic use during the stenting period. RESULTS Ninety-four patients completed the study. We noted significant decreases in the total IPSS scores (p = 0.002), irritative subscore (p = 0.039), QoL (p = 0.001), flank pain (p = 0.013), voiding pain (p = 0.01) and amount of analgesics used (p = 0.02) in the groups. However, neither the obstructive subscore nor the suprapubic pain improved significantly (p = 0.251 and p = 0.522, respectively). The patients receiving terazosin plus tolterodine experienced significant reductions in the total IPSS, irritative symptoms, QoL, flank pain, voiding pain and decreased analgesics use compared with those patients receiving placebo. However, compared with placebo, terazosin monotherapy did not affect pain levels, and tolterodine monotherapy did not improve QoL, flank pain or analgesics use. CONCLUSIONS Terazosin plus tolterodine improves ureteral stent-related complications, including irritative symptoms, the amount of analgesics used, QoL, flank pain and voiding pain but does not decrease obstructive symptoms or suprapubic pain. This trial was registered at www.clinicaltrials.gov as NCT01530243.
Collapse
Affiliation(s)
- Ali Tehranchi
- Department of Urology, Urmia University of Medical Sciences, Urmia, Iran
| | | | | | | |
Collapse
|
36
|
Arlen AM, Merriman LS, Heiss KF, Cerwinka WH, Elmore JM, Massad CA, Smith EA, Broecker BH, Scherz HC, Kirsch AJ. Emergency room visits and readmissions after pediatric urologic surgery. J Pediatr Urol 2014; 10:712-6. [PMID: 24239305 DOI: 10.1016/j.jpurol.2013.09.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 09/30/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Reducing readmissions has become a focal point to increase quality of care while reducing costs. We report all-cause unplanned return visits following urologic surgery in children at our institution. MATERIALS AND METHODS Children undergoing urology procedures with returns within 30 days of surgery were identified. Patient demographics, insurance status, type of surgery, and reason for return were assessed. RESULTS Four thousand and ninety-seven pediatric urology surgeries were performed at our institution during 2012, with 106 documented unplanned returns (2.59%). Mean time from discharge to return was 5.9 ± 4.9 days (range, 0.3-24.8 days). Returns were classified by chief complaint, including pain (32), infection (30), volume status (14), bleeding (11), catheter concern (8), and other (11). Circumcision, hypospadias repair, and inguinal/scrotal procedures led to the majority of return visits, accounting for 21.7%, 20.7%, and 18.9% of returns, respectively. Twenty-two returns (20.75%) resulted in hospital readmission and five (4.72%) required a secondary procedure. Overall readmission rate was 0.54%, with a reoperation rate of 0.12%. CONCLUSIONS The rate of unplanned postoperative returns in the pediatric population undergoing urologic surgery is low, further strengthening the argument that readmission rates in children are not necessarily a productive focal point for financial savings or quality control.
Collapse
Affiliation(s)
- Angela M Arlen
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | - Laura S Merriman
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Kurt F Heiss
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Wolfgang H Cerwinka
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - James M Elmore
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Charlotte A Massad
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Edwin A Smith
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Bruce H Broecker
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Hal C Scherz
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Andrew J Kirsch
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
| |
Collapse
|
37
|
Sanguedolce F, Millán-Rodriguez F, Santillana-Altimira JM, Fantova-Alonso A, Sánchez-Martín FM, Angerri-Feu O, Martinez JML, Keeley FX, Joshi HB, Villavicencio-Mávrich H. The Spanish Linguistic Validation of the Ureteral Stent Symptom Questionnaire. J Endourol 2014; 28:237-42. [DOI: 10.1089/end.2013.0325] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | | | | | - Oriol Angerri-Feu
- Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Francis X. Keeley
- Bristol Urological Institute, Southmead Hospital, University of Bristol, Bristol, United Kingdom
| | - Hrishi B. Joshi
- Urology Department, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, Wales
| | | |
Collapse
|
38
|
Matani YS, Al-Ghazo MA, Al-azab RS, Bani-hani O, Rabadi DK. Emergency double-J stent insertion following uncomplicated Ureteroscopy: risk-factor analysis and recommendations. Int Braz J Urol 2013; 39:203-8. [PMID: 23683666 DOI: 10.1590/s1677-5538.ibju.2013.02.08] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 01/15/2013] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Emergency double-J (DJ) stenting following ″uncomplicated″ ureteroscopic (UURS) stone treatment is both morbid and costly. Our study aims at identifying those patients who are more likely to require such an extra procedure. Handling of this complication will also be highlighted. MATERIALS AND METHODS 319 cases of UURS cases were selected out of 903 patients, who were admitted for URS stone treatment at King Abdullah University Hospital during the period from May, 2003 to December, 2010. Thirty-eight of them (11.9%) had emergency post-URS DJ stenting within 24 hours of discharge. The medical records of all UURS cases were retrospectively reviewed. Comparison in demographic and stone-related variables was made using 2-paired t-test with P < 0.05. Operative findings of 38 stented patients were outlined. RESULTS Significant risk factors for emergency stenting were noted in males with larger (> 1.5 cm) and proximal stones (38 stented vs. 281 unstented). Operative risk factors among the 38 patients were: initial procedure time > 45 minutes (42.1%), ureteral wall edema (21.1%), repeated access for stones > 1.5 cm (21.1%), impacted stone (10.5%) and ignored or missed stones/fragments (4.6%). CONCLUSIONS The need for emergency DJ stenting following UURS stone treatment is not uncommon. The routine insertion is impractical and weakly-supported. With risk-factor stratification, selective and individualized DJ stenting policy is recommended.
Collapse
Affiliation(s)
- Yousef S Matani
- Department of General Surgery and Urology and Department of Anaesthesia Jordan University of Science and Technology, Faculty of Medicine, King Abdullah University Hospital, Irbid, Jordan.
| | | | | | | | | |
Collapse
|
39
|
Olvera-Posada D, Suárez-Santos M, Castillejos-Molina R, Gabilondo-Navarro F, Méndez-Probst CE. Validation of the Spanish version of Ureteral Stent Symptom Questionnaire: prevalence of symptoms in a tertiary care center in Mexico. J Endourol 2013; 28:377-82. [PMID: 24112085 DOI: 10.1089/end.2013.0537] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To develop and to validate the Spanish version of the Ureteral Stent Symptom Questionnaire (USSQ). Describe the prevalence of symptoms associated with the presence of ureteral stent in a Spanish-speaking population. METHODS We developed and delivered the Spanish USSQ version to patients who underwent ureteral stent placement after endourological procedures. We determined the internal consistency and the instrument's sensitivity to change. Results of the patients were compared with a control group of healthy individuals. We analyzed the prevalence of symptoms in the six domains of the questionnaire and the overall quality of life. We compared the means of the results by gender to find significant differences in associated symptoms. RESULTS We obtained good internal consistency values of the instrument. Significant differences were obtained after sensitivity to change analysis in the scores of all domains except sexual performance. The correlation between the domains of urinary symptoms, pain, and general health was high. The analysis of specific symptoms showed important affection in all domains, being more significant in urinary symptoms and pain. The ureteral catheter also affected the daily life and work performance. There were no significant differences when comparing the symptoms by gender or age. CONCLUSIONS Spanish version of the USSQ is appropriate for assessing the symptoms associated with ureteral stent in the Spanish-speaking population. The ureteral catheter significantly affects the various aspects of life in this population.
Collapse
Affiliation(s)
- Daniel Olvera-Posada
- Urology Department, Instituto Nacional de Nutrición Salvador Zubirán, Mexico City, México
| | | | | | | | | |
Collapse
|
40
|
Liatsikos E, Kyriazis I, Neuhaus J, Kallidonis P, Georgiopoulos I, Franz T, Al-Aown A, Sakellaropoulos G, Stolzenburg JU. Direct Effects of Vardenafil on the Ureter:In VitroInvestigation and Potential Clinical Applications of Intralumenal Administration. J Endourol 2013; 27:1400-4. [DOI: 10.1089/end.2012.0612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Iason Kyriazis
- Department of Urology, University of Patras, Patras, Greece
| | | | | | | | - Toni Franz
- Department of Urology, University of Leipzig, Germany
| | | | | | | |
Collapse
|
41
|
Nair R, Drinnan NRT, Symes A. A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: a prospective, randomised, double-blind, placebo-controlled trial. BJU Int 2013; 111:E265-6. [PMID: 23578240 DOI: 10.1111/bju.12128_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
42
|
Lee YJ, Huang KH, Yang HJ, Chang HC, Chen J, Yang TK. Solifenacin improves double-J stent-related symptoms in both genders following uncomplicated ureteroscopic lithotripsy. Urolithiasis 2013; 41:247-52. [DOI: 10.1007/s00240-013-0554-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 03/06/2013] [Indexed: 10/27/2022]
|
43
|
|