1
|
Xiang N, Hu Y, Peng W, Luo M, Yang Y, Zhang Q. Comparing efficacy and safety of mirabegron, tamsulosin, and solifenacin in ureteral stent-related symptoms: outcomes from a network meta-analysis. Transl Androl Urol 2024; 13:699-707. [PMID: 38855609 PMCID: PMC11157398 DOI: 10.21037/tau-23-642] [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] [Received: 12/12/2023] [Accepted: 03/17/2024] [Indexed: 06/11/2024] Open
Abstract
Background Although ureteral stents are a well-established and commonly used method for renal drainage, the ureteral stent-related symptoms (SRSs) they cause in patients cannot be ignored. It is currently unclear whether mirabegron has a place in the treatment of SRSs. Our study aims to systematically evaluate the efficacy and safety of mirabegron in treating SRSs in adult patients. Methods Through a systematical search of multiple scientific databases before August 2023, we performed a systematic review and meta-analysis of the primary outcomes of interest according to the PRISMA. Analysis was performed under multivariate random-effects network models and effects of drugs was ranked with surface under the cumulative ranking curves (SUCRA) probabilities. Results Sixteen studies involving 2,002 patients were included. All regimens (including mirabegron, solifenacin, and tamsulosin) were significantly better than placebo in urinary symptoms. Solifenacin was associated with more adverse drug events than mirabegron and tamsulosin. The SUCRA values showed that mirabegron was the best in the outcomes of body pain (71.5%), sexual matters (76.4%), and adverse events (70.5%). Solifenacin was the best in the outcomes of urinary symptoms (73.1%), general health (81.0%), and work performance (85.1%). Tamsulosin had the lowest rate of all outcomes. Conclusions Compared with traditional drugs for relieving SRSs, mirabegron performs best in terms of alleviating body pain, sexual matters, and adverse events, with little difference in urinary symptoms and general health. Further high-quality prospective double-blinded randomized controlled trials (RCTs) are required to provide sufficient evidence supporting our observations.
Collapse
Affiliation(s)
- Nana Xiang
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
- Department of Urology, Nanchong Central Hospital (Nanchong Clinical Research Center), Nanchong, China
| | - Yanhua Hu
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
- Department of Urology, Nanchong Central Hospital (Nanchong Clinical Research Center), Nanchong, China
| | - Wenchun Peng
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
| | - Mei Luo
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
| | - Yang Yang
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
| | - Qiuhua Zhang
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
| |
Collapse
|
2
|
Polat ME, Karaaslan M, Yilmaz M, Olcucuoglu E, Sirin ME. The effect of ureteral double J stent insertion on work performance in patients undergoing endoscopic stone treatment. Cent European J Urol 2024; 77:117-121. [PMID: 38645805 PMCID: PMC11032031 DOI: 10.5173/ceju.2023.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/23/2023] [Accepted: 12/10/2023] [Indexed: 04/23/2024] Open
Abstract
Introduction Despite the developments in the material of the double J (DJ) stents and the production of thinner ones of desired sizes, patients continue to experience troublesome DJ stent-related symptoms in their lives. This study aimed to determine how DJ stenting affects patients' work performance after endoscopic stone surgery. Material and methods A total of 107 patients underwent placement of a ureteral stent after ureterorenoscopy (URS)/retrograde intrarenal surgery (RIRS), and only active and full-time working patients were included. All patients were asked to complete the validated Turkish version of the work performance score (WPS) questionnaire in the Ureteral Stent Symptom Questionnaire (USSQ) the day before stent removal and again one month after stent removal. Results Of the participants, 32.7% (n = 35) were female and 67.3% (n = 72) were male; the mean age was 41 (19-80) years. The workday loss had no statistically significant correlation with patient BMI, stone size, or stent indwelling time (p >0.005); however, a statistically significant negative correlation was detected with patient age (r = -0.335, p <0.001). The medians of WPSs with the stent and without the stent were 6 (3-15) and 3 (3-12), respectively (p <0.001). Conclusions Although DJ catheterization is a crucial tool for urological practice, it may increase the social and economic burden of patients due to reduced work performance and lost workdays. Therefore, limiting the duration of the DJ stent's stay and providing treatments to minimize patient symptoms will positively impact their professional lives. It would be beneficial to avoid DJ stenting in routine practice unless medically necessary.
Collapse
Affiliation(s)
- Muhammed Emin Polat
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | | - Mehmet Yilmaz
- Department of Urology, Asklepios Klinik Triberg, Triberg, Germany
| | - Erkan Olcucuoglu
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Emin Sirin
- University of Health Sciences, Dıskapi Yilidirim Beyazit Research and Training Hospital, Ankara, Turkey
| |
Collapse
|
3
|
Ciayadi TA, Palinrungi MA, Kholis K, Hendarto J, Syahrir S, Syarif S, Azis A. A randomized controlled trial study on effectiveness between tadalafil versus combination mirabegron and solifenacin on treatment of ureteral stent-related symptoms. Pan Afr Med J 2023; 46:2. [PMID: 37928219 PMCID: PMC10620325 DOI: 10.11604/pamj.2023.46.2.38100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 08/22/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction ureteral stents have common complications like ureteral stent-related symptoms (SRSs). This study investigated the effectiveness of tadalafil compared to mirabegron and solifenacin combination therapy in patients with ureteral SRSs after double-J (DJ) stent insertion. Methods this double-blind, randomized clinical trial used consecutive random sampling in participants with SRSs after double-J stent insertion. The study was conducted at four different hospitals in Makassar, Indonesia, from July to December 2020. Ureteral stent-related morbidity indices which analyzed include urinary symptoms, pain, general health, quality of work, and sex scores. All of the indices were measured by ureteral symptom score questionnaire for the first, second, third, and fourth weeks after drug consumption, either tadalafil 10 mg/day (group A, n=25) and a combination of mirabegron 25 mg/day and solifenacin 5 mg/day (group B, n=28). Results before the treatment procedure, the groups were comparable in age, gender, body mass index, DJ stent procedures, type, and indication. In general, the score in all parameters declined over the follow-up time for both groups. Group A had a lower urinary symptom score than group B at week III and week IV (all p-value < 0.001). In addition, group A had a lower pain score, general condition, work activity, and other complaints than group B at week II, week III, and week IV (all p-value <0.001). The sexual activity score is comparable between the group, except in week I. Conclusion according to our results, we suggest tadalafil to minimize stent-related urinary symptoms and improve general health in patients with double J stent.
Collapse
Affiliation(s)
- Tjia Adynata Ciayadi
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Muhammad Asykar Palinrungi
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Khoirul Kholis
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Joko Hendarto
- Department of Public Health, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Syakri Syahrir
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Syarif Syarif
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Abdul Azis
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| |
Collapse
|
4
|
Pecoraro A, Peretti D, Tian Z, Aimar R, Niculescu G, Alleva G, Piana A, Granato S, Sica M, Amparore D, Checcucci E, Manfredi M, Karakiewicz P, Fiori C, Porpiglia F. Treatment of Ureteral Stent-Related Symptoms. Urol Int 2023; 107:288-303. [PMID: 34818261 DOI: 10.1159/000518387] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of the study was to assess the effectiveness of the main classes of drugs used at reducing morbidity related to ureteric stents. SUMMARY After establishing a priori protocol, a systematic electronic literature search was conducted in July 2019. The randomized clinical trials (RCTs) selection proceeded in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and was registered (PROSPERO ID 178130). The risk of bias and the quality assessment of the included RCTs were performed. Ureteral Stent Symptom Questionnaire (USSQ), International Prostate Symptom Score (IPSS), and quality of life (QoL) were pooled for meta-analysis. Mean difference and risk difference were calculated as appropriate for each outcome to determine the cumulative effect size. Fourteen RCTs were included in the analysis accounting for 2,842 patients. Alpha antagonist, antimuscarinic, and phosphodiesterase (PDE) inhibitors significatively reduced all indexes of the USSQ, the IPSS and QoL scores relative to placebo. Conversely, combination therapy (alpha antagonist plus antimuscarinic) showed in all indexes of the USSQ, IPSS, and QoL over alpha antagonist or antimuscarinic alone. On comparison with alpha blockers, PDE inhibitors were found to be equally effective for urinary symptoms, general health, and body pain parameters, but sexual health parameters improved significantly with PDE inhibitors. Finally, antimuscarinic resulted in higher decrease in all indexes of the USSQ, the IPSS, and QoL relative to alpha antagonist. KEY MESSAGE Relative to placebo, alpha antagonist alone, antimuscarinics alone, and PDE inhibitors alone have beneficial effect in reducing stent-related symptoms. Furthermore, there are significant advantages of combination therapy compared with monotherapy. Finally, PDE inhibitors are comparable to alpha antagonist, and antimuscarinic seems to be more effective than alpha antagonist alone.
Collapse
Affiliation(s)
- Angela Pecoraro
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Dario Peretti
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Hospital Center, Montreal, Québec, Canada
| | - Roberta Aimar
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Gabriel Niculescu
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Giorgio Alleva
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Alberto Piana
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Stefano Granato
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Michele Sica
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Daniele Amparore
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Enrico Checcucci
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Matteo Manfredi
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Pierre Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Hospital Center, Montreal, Québec, Canada
| | - Cristian Fiori
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| |
Collapse
|
5
|
Habib B, Hassan S, Roman M, Anwar K, Latif A. Comparative Study of Externalized Ureteral Catheter Versus Double-J Stent on Percutaneous Nephrolithotomy: A Randomized Controlled Trial. Cureus 2022; 14:e22967. [PMID: 35415027 PMCID: PMC8994048 DOI: 10.7759/cureus.22967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background: External ureteral catheter (EUC) and double-J stent are both commonly used to drain upper urinary tract in percutaneous nephrolithotomy (PCNL). We compared the outcomes of using EUC versus double-J stent in performing PCNL in patients with renal stones in our settings in order to identify a better technique for the management of renal stones in terms of postoperative stent-related symptoms. Methods: This randomized controlled trial was conducted at the Department of Urology, PAEC General Hospital, Islamabad, from January 2020 to December 2020. A total of 80 patients of either gender between ages 18 and 70 years planned for PCNL were enrolled and randomized into group I (double-J stent) and group II (EUC). Outcomes of the procedure were compared in both groups. Results: There were 62.5% of patients in group I who demonstrated stent-related symptoms compared to 22.5% in group II (p=0.001). No statistically significant difference was noted in other outcome variables like urinary leak (10% vs. 20%, p=0.210), post-procedure fever (25% vs. 22.5%, p=0.793), mean analgesia requirement (60.8 mg vs. 58.5 mg, p=0.685), and mean length of hospital stay (3.9 days vs. 4.2 days, p=0.330). Conclusion: Stent-related symptoms were demonstrated by a significantly lesser number of patients who underwent PCNL with EUC when compared with patients who underwent PCNL with double-J stent. For other outcome variables (urinary leak, post-procedure fever, mean analgesia requirement, and mean length of hospital stay ), no significant difference was noted among both the groups.
Collapse
|
6
|
Kholis K, Palinrungi MA, Syahrir S, Syarif, Azis A, Ricardo S, Faruk M. Neglected double-J stent with giant bladder stone: a case report. Pan Afr Med J 2021; 39:213. [PMID: 34630825 PMCID: PMC8486933 DOI: 10.11604/pamj.2021.39.213.29865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/15/2021] [Indexed: 12/04/2022] Open
Abstract
Double-J (DJ) stents have been widely utilized in urological practice. They are commonly used to relieve ureteral obstruction. Serious complications may occur when stents are left in place for long periods of time. In the present paper, we report a patient with a neglected DJ stent that had been inserted for five years after uterus-tumor surgery and led to a bladder stone. We report a case of a female who presented a bladder stone with a right DJ stent in the pelvic cavity. The stone was evident in radiological examination in an incidental finding. The treatment was transurethral cystolithotripsy. This case reminds us of the necessity of providing enough information and appropriate knowledge pertaining to the insertion of a ureteral stent. Transurethral cystolithotripsy is one of the treatment methods and can be suggested as a definitive method in consideration that it is a clinically effective and safe intervention.
Collapse
Affiliation(s)
- Khoirul Kholis
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Muhammad Asykar Palinrungi
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Syakri Syahrir
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Syarif
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Abdul Azis
- Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Stevent Ricardo
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Muhammad Faruk
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| |
Collapse
|
7
|
Özlü İ, Karaman Özlü Z, Kilinç T, Yayla A, Karabulut İ. Sexual dysfunction in patients after double-J catheterisation: A cross-sectional, prospective study. Int J Clin Pract 2021; 75:e14564. [PMID: 34165850 DOI: 10.1111/ijcp.14564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/19/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study was conducted to examine sexual dysfunction in patients after double-J catheterisation. MATERIALS AND METHODS This descriptive, cross-sectional and prospective study was conducted in a research and training hospital from June 2020 to February 2021. The data were collected from patients who visited the emergency clinic and were hospitalised in the urology clinic because of renal calculi. The study was completed with 192 patients. The data were collected using a patient introductory form, the International Index of Erectile Function (IIEF-15) and the 5-item Turkish version of the International Index of Erectile Function (IIEF-5). Then data were collected before double-J catheterisation, 1 month after catheterisation and a month after the catheter was removed. The data were evaluated using means, numbers, percentile distributions and the paired samples t test. RESULTS The patients' sexual function was negatively affected by double-J catheterisation, and this negative effect persisted for a month after removal of the double-J catheter. The differences in the patients' mean IIEF scores and sub-dimension scores before and after double-J catheterisation were statistically significant (P ˂ 0.001). A month after the double-J catheter was removed, the difference between their mean IIEF-5 scores was statistically significant (P ˂ 0.001). No erectile dysfunction was found in 50.0% of the patients before double-J catheterisation. A month after the catheter was removed, erectile dysfunction was found at different levels in 88% of the patients, and severe erectile dysfunction was found in 60.9% of the patients. CONCLUSION This study found that double-J catheterisation negatively affects patients' sexual function. Patients experience sexual dysfunction while the double-J catheter is in place and for a month after it is removed.
Collapse
Affiliation(s)
- İbrahim Özlü
- Emergency Department, Atatürk University, Erzurum, Turkey
| | - Zeynep Karaman Özlü
- Department of Surgical Nursing, Faculty of Nursing, Anesthesiology Clinical Research Office, Ataturk University, Erzurum, Turkey
| | - Tülay Kilinç
- Department of Surgical Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Ayşegül Yayla
- Urology Department, Regional Training and Research Hospital, Erzurum, Turkey
| | - İbrahim Karabulut
- Urology Department, Regional Training and Research Hospital, Erzurum, Turkey
| |
Collapse
|
8
|
Ghaed MA, Rezaei R, Shafeinia A, Maghsoudi R. Efficacy of cystone versus tamsulosin in treatment of stent-related lower urinary tract symptoms. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/20514158211000214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Double-J stent is a common tool used in urological procedures that is inserted for 2–6 weeks, but it may induce abdominal and flank pain, incontinence and irritative urinary symptoms. Alleviation of such symptoms would be useful to improve the patients’ quality of life. Accordingly, in this study, the efficacy of cystone versus tamsulosin in the treatment of double-J stent-related lower urinary tract symptoms was determined. Materials and methods: In this randomised clinical trial, 128 patients who required double-J stent insertion after transureteral lithotripsy during 2018–2019 were enrolled. They were randomly assigned to receive either cystone, tamsulosin, both, or placebo. The international prostate symptom score and visual analogue score data were recorded at baseline, after 2 and 4 weeks across the groups. Results: The international prostate symptom score and visual analogue score factors were statistically different across the case groups receiving cystone, tamsulosin and both drugs versus placebo ( P=0.001). Two weeks after drug administration, the visual analogue score and international prostate symptom score were not statistically different in the tamsulosin, cystone and dual therapy groups; however, after 4 weeks the cystone group had the lowest symptoms. Conclusion: Both tamsulosin and cystone are efficient drugs which would relieve stent-related lower urinary tract symptoms. The administration of cystone with or without tamsulosin for 4 weeks may have the best result in reducing the visual analogue score and international prostate symptom score. Level of evidence: Level I, 1b, therapeutic study, randomised controlled trial
Collapse
Affiliation(s)
- Mohammad Ali Ghaed
- Urology Department, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Rezaei
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Amineh Shafeinia
- Anesthesiology Department, Shahid Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Robab Maghsoudi
- Urology Department, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Arora A, Sane MS, Jadhao V, Maheshwari PN. Sexual dysfunction in Indian men undergoing Double J ureteral stenting following ureteroscopy-A prospective analysis. Andrologia 2020; 52:e13790. [PMID: 32776564 DOI: 10.1111/and.13790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/25/2020] [Accepted: 07/12/2020] [Indexed: 12/29/2022] Open
Abstract
This prospective study was aimed to evaluate the impact of an indwelling ureteral double-J stent on the sexual health of Indian men undergoing ureteroscopy. The first phase of the study included 30 men who were not counselled prior to stenting about possible sexual dysfunction, while in the next phase, 60 men were counselled about this. These 60 patients were assessed by a 6-point questionnaire: five questions from the International Index of Erectile Function-5 (IIEF-5) and an additional 6th question to assess pain during erection/ejaculation. Patients answered the questionnaire prior to ureteroscopy, at the time of stent removal and then 4 weeks after stent removal. A higher proportion of men in the second phase attempted sexual activity (68.3% vs. 26.7%; p < .001). Significant changes were noted in the total IIEF-5 score (mean 23.16 before vs. 15.65 after, p < .001) and individual IIEF-5 components: erection confidence (4.59 vs. 2.76, p = .017), maintenance ability (4.67 vs. 2.43, p = .006) and intercourse satisfaction (4.61 vs. 2.31, p < .001) and also the 'pain' question (2.83 post-stenting vs. 0.37 pre-stenting, p < .001). Most patients had a recovery of scores at 4 weeks after stent removal. Thus, ureteral DJ stenting leads to significant but temporary sexual dysfunction and patients need to be counselled regarding this.
Collapse
Affiliation(s)
- Amandeep Arora
- Department of Urology, Fortis Hospital Mulund, Mumbai, India
| | - Mahesh S Sane
- Department of Urology, Fortis Hospital Mulund, Mumbai, India
| | - Vivek Jadhao
- Department of Urology, Fortis Hospital Mulund, Mumbai, India
| | | |
Collapse
|
10
|
Role of phosphodiesterase inhibitors in stent-related symptoms: a systematic review and meta-analysis. World J Urol 2020; 38:2065. [PMID: 31359107 DOI: 10.1007/s00345-019-02893-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 10/26/2022] Open
|
11
|
Kim BS, Choi JY, Jung W. Does a Ureteral Stent with a Smaller Diameter Reduce Stent-Related Bladder Irritation? A Single-Blind, Randomized, Controlled, Multicenter Study. J Endourol 2020; 34:368-372. [DOI: 10.1089/end.2019.0482] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Bum Soo Kim
- Department of Urology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Jae Young Choi
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Wonho Jung
- Department of Urology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| |
Collapse
|
12
|
Deliveliotis K, Papatsoris AG, Skolarikos A, Mitsogiannis I, Tzannis K, Dellis AE. Management of stent-related symptoms with the use of α-blockers: A meta-analysis. Arab J Urol 2019; 18:14-21. [PMID: 32082629 PMCID: PMC7006658 DOI: 10.1080/2090598x.2019.1690824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 09/29/2019] [Indexed: 10/27/2022] Open
Abstract
Objectives: To assess the effectiveness of α-blockers at reducing stent-related morbidity compared to placebo using the Ureteric Symptom Score questionnaire (USSQ) at particular time points as originally set by the developers of the USSQ. Materials and methods: We conducted the study following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Eligible articles were identified by a search of the Medical Literature Analysis and Retrieval System Online (MEDLINE) database for the period from 1 January 2006 to 30 November 2018. The search strategy included specific keywords and only articles in English were considered eligible. A meta-analysis of randomised controlled trials was done according to methodological quality, placebo-control use, and USSQ completion at the time points of 1 and 4 weeks after insertion, and 4 weeks after stent removal. The mean differences with 95% confidence intervals were calculated for outcomes, with a P < 0.05 considered statistically significant. Results: In all, eight papers were included for analysis. At 1 week after stent insertion, α-blockers were associated with a significant decrease in the USSQ Urinary Index score (UIS), Pain Index score, General Health Index score (GHIS), Sex Index score, and Work Index score (WIS). At 4 weeks after stent insertion, α-blockers were associated with a significant decrease in the UIS, GHIS and WIS only, whilst at 4 weeks after stent removal, α-blockers were associated with a significant decrease in the UIS and GHIS. Conclusions: The oral administration of α-blockers or their combinations have been shown to relieve stent morbidity, especially during the early period of stenting. The use of selective agents can therefore be considered; however, there is still the need for uniformly designed multi-centre randomised studies. Abbreviations: MD: mean difference; QoL: quality of life; RCT: randomised controlled trial; SRS: stent-related symptoms; USSQ: Ureteric Symptom Score questionnaire.
Collapse
Affiliation(s)
- Konstantinos Deliveliotis
- 2nd Department of Urology, Sismanogleion General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios G Papatsoris
- 2nd Department of Urology, Sismanogleion General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Skolarikos
- 2nd Department of Urology, Sismanogleion General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Iraklis Mitsogiannis
- 2nd Department of Urology, Sismanogleion General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Kimon Tzannis
- Department of Clinical Therapeutics, University of Athens, National and Kapodistrian University of Athens Alexandra Hospital, Athens, Greece
| | - Athanasios E Dellis
- 1st Department of Urology, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,2nd Department of Surgery, Aretaieion Academic Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
13
|
Sharma G, Sharma AP, Mavuduru RS, Devana SK, Bora GS, Singh SK, Mandal AK. Role of phosphodiesterase inhibitors in stent-related symptoms: a systematic review and meta-analysis. World J Urol 2019; 38:929-938. [DOI: 10.1007/s00345-019-02862-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/24/2019] [Indexed: 10/26/2022] Open
|
14
|
Tamsulosin in urology: beyond benign prostatic hyperplasia. DRUGS & THERAPY PERSPECTIVES 2019. [DOI: 10.1007/s40267-019-00611-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
15
|
A randomized controlled trial evaluating sildenafil citrate in relieving ureteral stent-related symptoms. World J Urol 2018; 36:1877-1881. [DOI: 10.1007/s00345-018-2339-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/11/2018] [Indexed: 12/15/2022] Open
|
16
|
Bhattar R, Tomar V, Yadav SS, Dhakad DS. Comparison of safety and efficacy of silodosin, solifenacin, tadalafil and their combinations in the treatment of double-J stent- related lower urinary system symptoms: A prospective randomized trial. Turk J Urol 2018; 44:228-238. [PMID: 29733797 DOI: 10.5152/tud.2018.50328] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/07/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the efficacy and safety of silodosin, solifenacin, tadalafil and their combinations in reducing double J (DJ) stent-related symptoms (SRS). MATERIAL AND METHODS A total of 335 patients who underwent DJ stenting and develop SRS at 1st week were randomized into eight groups. Ureteral stent symptom questionnaire (USSQ) and Quality of life (QOL) scores were noted in each group: Group A-Silodosin (8 mg OD)+ Solifenacin (10 mg OD)+ Tadalafil (5 mg OD), B - Silodosin 8 mg OD, C - Solifenacin 10 mg OD, D- Tadalafil 5 mg OD, E- Silodosin (8 mg OD) + Solifenacin (10 mg OD), F- Silodosin (8 mg 0D)+ Tadalafil (5 mg OD), G- Solifenacin (10 mg OD)+ Tadalafil (5 mg OD) and H-placebo. Analgesic (diclofenac 50 mg) was given as per requirement. All groups received the drugs for 14 days and again USSQ, QOL score with analgesic requirement were noted in each group. RESULTS USSQ score was similar in all groups at 1st week but all groups (Groups A-G) led to significant decrease in USSQ score at 3rd week as compared to Group H with less requirement of analgesic. However when we compared groups with each other we found that mean USSQ score and analgesic requirement was favoring Group E as compared to other groups. Quality of life score was also best in Group E (mean 1.5) (p<0.05). CONCLUSION Combination therapy with silodosin and solifenacin (group E) was effective for relieving SRS with improved quality of life and less requirement of analgesic than any other groups and should be considered in patients who develop SRS.
Collapse
Affiliation(s)
| | - Vinay Tomar
- SMS Medical College, Jaipur, Rajasthan, India
| | | | | |
Collapse
|
17
|
Moradi M, Abdi H, Ebrahimi S, Rezaee H, Kaseb K. Effects of Tamsulosin and Tolterodine on double J stent-related symptoms: A double-blind, randomized, placebo-controlled trial. SAGE Open Med 2017; 5:2050312117696436. [PMID: 28344784 PMCID: PMC5349560 DOI: 10.1177/2050312117696436] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 02/03/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Ureteral double J stent are routinely applied for urologic patients although stent-related symptoms are common. Several attempts have been reported to minimize these symptoms. Objective: To compare Tolterodine, Tamsulosin, and placebo effects on double J stent–related symptoms. Material and method: In all, 125 patients (82 males and 43 females) with double J stent were randomly divided into three groups (group 1, n: 42, group2, n: 40 and group 3, n: 43). Each patient randomly received one pack of drug in different colors by a nurse unaware of the content to take Tamsulosin 0.4 mg before sleep (MODALUSINE), Tolterodine 2 mg twice a day or placebo once daily (capsules filled with starch): group 1 received placebo, group 2 Tamsulosin and group 3 Tolterodine for 1 month in a double-blind manner. Ureteral stent-related morbidity indices which analyzed include urinary symptom, pain, general health, quality of work and sex scores. All of indices measured by Ureteral Symptom Score Questionnaire for first and fourth weeks after drug consumption and the first week after double J stent removal (labeled as w1, w4, and w5, respectively). Result: The mean age was 44.8 years (range: 15–83 years). There was no statistically significant difference in background characteristics between groups (p value > 0.05). The most important and statistically significant results were Tolterodine-reduced urinary symptom score (p value = 0.001) and improved general health score (p value = 0.007) of the fourth week. The pain score in groups of Tamsulosin and Tolterodine significantly reduced between weeks 4 and 1 and 5 and 1 (both with the p value < 0.05), but in other indices, there was no significant difference between them. Conclusion: According to our results, we suggest Tolterodine to minimize stent-related urinary symptom and improve general health in patients with double J stent.
Collapse
Affiliation(s)
- Mahmoudreza Moradi
- Department of Urology in Imam Reza General Hospital & Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Abdi
- Department of Urology in Imam Reza General Hospital & Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sina Ebrahimi
- Department of Urology in Imam Reza General Hospital & Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Haress Rezaee
- Department of Urology in Imam Reza General Hospital & Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kaveh Kaseb
- Department of Urology in Imam Reza General Hospital & Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
18
|
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
|