Differences In Urinary Symptoms Research Articles

The effect of no oral antibiotic versus 7 days oral antibiotic during discharge in double J stented patients on stent related urinary tract infection: A randomized study.

To evaluate effects of 7 days oral antibiotic prophylaxis versus no antibiotics in the patients with DJ stents after 3 days iv antibiotic on discharge with respect to urinary tract infection and stent related symptoms. A prospective randomized study in 90 patients being stented post PCNL/URSL. Group A: no oral antibiotics was given at the time of discharge, Group B: 7 days of oral antibiotic was given at the time of discharge. Patients were followed up and outcomes were assessed in the form of lower urinary symptoms (LUTS), urine culture and sensitivity at 1 and 3 weeks and DJ stent culture and sensitivity on removal at 3 weeks. There was no significant difference in age, gender, type of surgery (PCNL/URSL), duration of DJ stent between the two groups. Patients in group A and Group B have comparable UTI and stent related symptoms at 1 and 3 weeks respectively (p = 0.95 and p = 0.916 respectively). Similarly, there were no marked difference in urine culture at 1 and 3 weeks, respectively between two groups (p = 0.71 and p = 0.63, respectively). Overall there were no significant differences in Urinary symptoms, urine culture/sensitivity at 1 and 3 weeks and also DJ stent culture and sensitivity on removal at 3 weeks between the two groups. The incidence of UTI and stent related symptoms are same in both the groups. Therefore, prescribing oral antibiotics on discharge in selected patient with DJ stent has no added benefit and should be avoided.

PD66-07 LOWER URINARY TRACT SYMPTOMS IN WOMEN FOLLOWING BIOLOGIC TRANSVAGINAL GRAFT VS. NATIVE TISSUE REPAIR FOR PELVIC ORGAN PROLAPSE

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction III (PD66)1 Sep 2021PD66-07 LOWER URINARY TRACT SYMPTOMS IN WOMEN FOLLOWING BIOLOGIC TRANSVAGINAL GRAFT VS. NATIVE TISSUE REPAIR FOR PELVIC ORGAN PROLAPSE Gina Northington, Ricardo Gonzalez, Jennifer Wu, Felicia Lane, Benjamin Brucker, and Peter Rosenblatt Gina NorthingtonGina Northington More articles by this author , Ricardo GonzalezRicardo Gonzalez More articles by this author , Jennifer WuJennifer Wu More articles by this author , Felicia LaneFelicia Lane More articles by this author , Benjamin BruckerBenjamin Brucker More articles by this author , and Peter RosenblattPeter Rosenblatt More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002110.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To compare postoperative lower urinary tract symptoms in women surgically treated for pelvic organ prolapse (POP) with a biologic transvaginal graft (TVG) vs. traditional native tissue repair (NTR). METHODS: This is a secondary analysis of a prospective, non-randomized, parallel cohort, multi-center trial where subjects received TVG or NTR to repair anterior and/or apical POP. The primary endpoint was non-inferiority (NI) of TVG repair to NTR in treatment success and SAE rate at 36 months compared to baseline. The primary objective of this study was to compare the occurrence of de novo or worsening urinary symptoms. Symptoms were recorded using validated questionnaires (Urinary Distress Inventory (UDI-6) and Urinary Impact Questionnaire (UIQ-7)). Baseline and post-operative urinary symptoms for each treatment group were compared using two sample t-test. Adverse event rate was compared between TVG and NTR using log-rank test. RESULTS: Baseline urinary symptoms from UIQ-7 and UDI-6 were significantly higher in the TVG group (n=228) compared to NTR (n=485) (Table 1). There were no other significant differences in baseline characteristics after propensity score stratification, and treatment success at 36 months was similar between both groups. The overall SAE rate of TVG (5.3%) was NI to NTR (2.7%) (group difference of 2.0%, 90% CI [0.8%, 4.7%]) at the pre-specified margin of 11.6%; however de novo voiding dysfunction was significantly greater in TVG (15.4%) vs. NTR (4.7%) (p<0.001). De novo stress urinary incontinence (SUI) was also significantly higher in TVG compared to NTR (3.1% vs. 0.8%, p=0.02). Conversely, worsening SUI occurred more frequently in the NTR group compared to TVG (3.9% vs. 0.9%, p=0.003). Postoperatively, there were no significant differences in urinary symptoms on UIQ-7 and UDI-6 at each time point. CONCLUSIONS: Biologic transvaginal graft for the treatment of anterior and/or apical vaginal prolapse was overall safe and effective but led to significantly more de novo voiding dysfunction compared to native tissue repair; this may be related to higher baseline urinary symptoms in the transvaginal graft group noted on UIQ-7 and UDI-6. Postoperatively, lower urinary tract symptoms were similar between both groups. Source of Funding: Boston Scientific Corporation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1161-e1161 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gina Northington More articles by this author Ricardo Gonzalez More articles by this author Jennifer Wu More articles by this author Felicia Lane More articles by this author Benjamin Brucker More articles by this author Peter Rosenblatt More articles by this author Expand All Advertisement Loading ...

Pilot randomized controlled trial of a hypnosis intervention for women with bladder pain syndrome.

To evaluate the feasibility and acceptability of a randomized controlled trial of a hypnosis intervention for the treatment of bladder pain syndrome/interstitial cystitis (BPS/IC) in women. We conducted a parallel arm, non-blinded, pilot randomized controlled trial of standardized hypnosis sessions including a hypnosis web tool versus usual care in adult women with BPS/IC. Pilot study outcomes included feasibility domains: process, resources and management, safety, and acceptability. Clinical outcomes of lower urinary tract symptoms and quality of life were measured using validated questionnaires at baseline and at the end of the 4-week intervention. We randomized 29 out of 30 (96.7%) eligible women. In the hypnosis group, 12 of 15 (80.0%) subjects completed the 4-week intervention and follow up, and 13 of 14 (92.9%) in the usual care group. In the hypnosis group, adherence to the standardized sessions was 80% and participants used the web-based tool for an average of 5.6 ± 2.7 times per week. Scores for emotional distress, relaxation, pain severity and expected bladder symptoms significantly improved during the first two of three planned hypnosis sessions (all p < 0.05). Improvement in quality of life scores was greater in the hypnosis group than the usual care group (-2.6 ± 2.3 vs. -0.9 ± 1.1, p = 0.04). There were no significant between-group differences in urinary symptoms or bladder pain. No adverse events were reported. A hypnosis intervention for the treatment of bladder pain syndrome/interstitial cystitis is feasible, acceptable, safe, and may improve quality of life.

Rapamycin enhances BCG-specific γδ T cells during intravesical BCG therapy for non-muscle invasive bladder cancer: a randomized, double-blind study

BackgroundAlthough intravesical BCG is the standard treatment of high-grade non-muscle invasive bladder cancer (NMIBC), response rates remain unsatisfactory. In preclinical models, rapamycin enhances BCG vaccine efficacy against tuberculosis and the...

Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement: A systematic review and meta-analysis.

PurposeTo assess the effects of Serenoa repens alone or in combination with other phytotherapy compared to placebo in men with LUTS due to benign prostatic enlargement.Materials and MethodsFollowing a registered protocol (CRD42021226655), we searched (December 2020) MEDLINE, CENTRAL, Embase, ClinicalTrials.gov, WHO-ICTRP trials platform and other sources with no restrictions on language, publication date or status. We included randomized controlled trials, and we critically appraised them using the Cochrane Tool for Risk of Bias Assessment (RoB 2). We conducted random-effects meta-analysis when appropriate. The primary outcomes included urinary symptoms score, quality of life, and adverse events. The certainty of the evidence was rated using GRADE.ResultsWe included 27 trials with 4,853 participants. S. repens results in little to no difference in urinary symptoms, quality of life, and adverse events at short- and long-term follow-up. S. repens combined with other phytotherapy may slightly reduce urinary symptoms at short-term follow-up, but the results are uncertain. The results on quality of life and adverse events are also very uncertain.ConclusionsS. repens alone may result in no clinical benefits for men with LUTS. There is greater uncertainty in the effects of S. repens in combination with other phytotherapy.

Risk of Urinary Tract Infection Symptoms after Posthysterectomy Cystoscopy with 50% Dextrose as Compared with Saline Cystoscopy with Indigo Carmine

Compare odds of postoperative urinary symptoms in women who had cystoscopy after benign laparoscopic hysterectomy with 50% dextrose and with normal saline solution with intravenous indigo carmine. Retrospective cohort study. Two tertiary care centers. All women who underwent benign laparoscopic hysterectomy and intraoperative cystoscopy carried out by a single surgeon. We compared postoperative urinary symptoms in patients who received 50% dextrose cystoscopy fluid (January 2016-June 2017) with those who received saline cystoscopy with intravenous indigo carmine (November 2013-April 2014). A total of 96 patients had cystoscopy with 50% dextrose and 104 with normal saline with intravenous indigo carmine. Differences in baseline characteristics of the two groups of participants mainly reflected institutional population diversity: age (45.2 vs 41.9, p = .01), body mass index (26.9 vs 33.4, p <.01), race, current smoking status (1% vs 7.8%, p = .04), diabetes (2.1% vs 11.5%, p = .01), history of abdominal surgery (53.1% vs 74%, p <.01), hysterectomy type, receipt of intraoperative antibiotics (92.7% vs 100%, p <.01), recatheterization (10.4% vs 0%, p <.01), and removal of catheter on postoperative day 0 (66.7% vs 12.5%, p <.01). Urinary symptoms were similar for 50% dextrose and saline (12.5% vs 7.7%, p = .19). After adjusting for age, body mass index, race, diabetes, and day of catheter removal, there remained no significant differences in urinary symptoms between the groups (odds ratio 3.19 [95% confidence interval, 0.82-12.35], p = .09). One immediate bladder injury was detected in the saline group and 1 delayed lower urinary tract injury in the 50% dextrose group. Overall, most women experienced no urinary symptoms after benign laparoscopic hysterectomy. There were no significant differences in postoperative urinary symptoms or empiric treatment of urinary tract infection after the use of 50% dextrose cystoscopy fluid as compared with normal saline. The previous finding of increased odds of urinary tract infection after dextrose cystoscopy may be due to use in a high-risk population.

Effects of biofeedback-based sleep improvement program on urinary symptoms and sleep patterns of elderly Korean women with overactive bladder syndrome

BackgroundThe prevalence of overactive bladder syndrome (OAB) increases with age. Sleep disturbances in elderly individuals with OAB is a common problem. The purpose of this study was to examine the effects of a biofeedback-based sleep improvement (BBSI) program on urinary symptoms and sleep patterns in elderly Korean women with OAB.MethodsA non-equivalent control group pre−/post-test design was used. Elderly women with OAB were assigned to an intervention group (n = 20) or a control group (n = 18). The BBSI program was implemented in the intervention group for 12 weeks, while two educational sessions of general sleep hygiene and lifestyle modification were provided to the control group. Using SPSS 23.0, the data were analyzed by descriptive analysis using the chi-square test, Fisher’s exact test, Mann-Whitney test, and Wilcoxon test.ResultsAfter the 12-week BBSI program, significant improvements were found in the intervention group’s the square root of the mean squared differences of successive R-R intervals (p = 0.025), low frequency/high frequency ratio (p = 0.006), and epinephrine (p = 0.039). We also observed a significant difference in urinary symptoms, sleep efficiency, wake after sleep onset, number of awakenings, and number of awakenings within 3 h after sleep onset (p < 0.001, p = 0.004, p = 0.001, p = 0.001, and p = 0.048, respectively). However, no significant changes were found in these variables in the control group.ConclusionsThe BBSI program effectively improved urinary symptoms and sleep patterns of elderly Korean women with OAB. Further longitudinal research is required to investigate the sustainability and effects of the BBSI program.Trial registrationKCT0003882. Date of registration: 02/05/2019. Retrospectively registered.

Physical Activity and Stress Incontinence in Women.

This review aims to discuss the current literature addressing associations between physical activity and stress urinary incontinence in women. Multiple cross-sectional studies utilize survey questionnaires to determine prevalence of stress urinary incontinence, impact of various types and intensities of physical activity on stress urinary incontinence, and explain differences in urinary symptoms among active women. Although there is evidence for increased rates of stress incontinence among women who are physically active, pathophysiology is not fully understood and there is a need for additional research exploring changes to the pelvic floor during exercise. Future research focusing on the mechanism in which physical activity contributes to urinary symptoms can guide development of primary preventions for stress urinary incontinence.

The SmartTarget Biopsy Trial: A Prospective, Within-person Randomised, Blinded Trial Comparing the Accuracy of Visual-registration and Magnetic Resonance Imaging/Ultrasound Image-fusion Targeted Biopsies for Prostate Cancer Risk Stratification

BackgroundMultiparametric magnetic resonance imaging (mpMRI)-targeted prostate biopsies can improve detection of clinically significant prostate cancer and decrease the overdetection of insignificant cancers. It is unknown whether visual-registration targeting is sufficient or augmentation with image-fusion software is needed. ObjectiveTo assess concordance between the two methods. Design, setting, and participantsWe conducted a blinded, within-person randomised, paired validating clinical trial. From 2014 to 2016, 141 men who had undergone a prior (positive or negative) transrectal ultrasound biopsy and had a discrete lesion on mpMRI (score 3–5) requiring targeted transperineal biopsy were enrolled at a UK academic hospital; 129 underwent both biopsy strategies and completed the study. InterventionThe order of performing biopsies using visual registration and a computer-assisted MRI/ultrasound image-fusion system (SmartTarget) on each patient was randomised. The equipment was reset between biopsy strategies to mitigate incorporation bias. Outcome measurements and statistical analysisThe proportion of clinically significant prostate cancer (primary outcome: Gleason pattern ≥3+4=7, maximum cancer core length ≥4mm; secondary outcome: Gleason pattern ≥4+3=7, maximum cancer core length ≥6mm) detected by each method was compared using McNemar's test of paired proportions. Results and limitationsThe two strategies combined detected 93 clinically significant prostate cancers (72% of the cohort). Each strategy detected 80/93 (86%) of these cancers; each strategy identified 13 cases missed by the other. Three patients experienced adverse events related to biopsy (urinary retention, urinary tract infection, nausea, and vomiting). No difference in urinary symptoms, erectile function, or quality of life between baseline and follow-up (median 10.5 wk) was observed. The key limitations were lack of parallel-group randomisation and a limit on the number of targeted cores. ConclusionsVisual-registration and image-fusion targeting strategies combined had the highest detection rate for clinically significant cancers. Targeted prostate biopsy should be performed using both strategies together. Patient summaryWe compared two prostate cancer biopsy strategies: visual registration and image fusion. A combination of the two strategies found the most clinically important cancers and should be used together whenever targeted biopsy is being performed.

Cycling and Female Sexual and Urinary Function: Results From a Large, Multinational, Cross-Sectional Study

BackgroundBicycle riding has become an increasingly popular mode of transportation and exercise, especially among women, and previous studies have demonstrated a relationship between cycling and sexual dysfunction, albeit using non-validated questionnaires. AimWe aimed to explore the relationship between cycling and sexual and urinary dysfunction. MethodsCyclists were recruited to complete a survey through Facebook advertisements and outreach to sporting clubs across 5 English-speaking countries. Swimmers and runners were recruited as a comparison group. OutcomesParticipants were queried using validated questionnaires, including the Female Sexual Function Index, the American Urological Association Symptom Index, and non-validated questions about history of urinary tract infections (UTIs), genital numbness, and genital saddle sores (all self-reported). Results3,118 (53.3%) Women completed the survey, comprising 1,053 (34%) non-cyclists, 1,656 (53%) low-intensity cyclists, and 409 (13%) high-intensity cyclists. After adjusting for age, body mass index, hypertension, diabetes, ischemic heart disease, tobacco use, race, marital status, urinary symptoms, and sexual activity, high-intensity cyclists had lower odds of self-reported sexual dysfunction compared to non-cyclists (adjusted odds ratio [aOR] 0.7, P = .02). There were no statistically significant differences in urinary symptoms across groups. Compared to non-cyclists, both low- and high-intensity cyclists had higher odds of reporting a previous UTI (aOR 1.4, P < .001, and aOR 1.4, P = .009, respectively), genital numbness (odds ratio [OR] 6.5, P < .001, and OR 9.1, P < .001, respectively), and saddle sores (OR 6.3, P < .001, and OR 22.7, P < .001, respectively). Clinical TranslationWomen cyclists were more likely to report other genitourinary conditions, including UTIs, genital numbness, and saddle sores. ConclusionsThis is the largest study comparing cyclists to other athletes with respect to sexual and urinary function. The study is limited by its cross-sectional design and sampling methods. We found that women cyclists were no more likely to report sexual dysfunction or urinary symptoms than swimmers or runners.Gaither TW, Awad MA, Murphy GP, et al. Cycling and Female Sexual and Urinary Function: Results From a Large, Multinational, Cross-Sectional Study. J Sex Med 2018;15:510–518.

Parasacral transcutaneous electrical nerve stimulation for overactive bladder in constipated children: The role of constipation

Parasacral transcutaneous electrical nerve stimulation (TENS) is an effective method for the treatment of overactive bladder (OAB), and, additionally, it accelerates bowel transit time. Therefore, not only does parasacral transcutaneous electrical nerve stimulation (TENS) improve lower urinary tract symptoms (LUTS), but it also resolves the problem of constipation in a significant number of children. Since TENS has a positive effect on LUTS and on the symptoms of fecal retention, it is possible that its action regarding OAB could be directly associated with the improvement in constipation. In other words, the positive effect of parasacral TENS in OAB would be because constipation was resolved. The objective of this study was to test that hypothesis. To test the hypothesis that the positive effect of parasacral TENS in OAB would be because constipation had improved with this method. In this prospective study, children with OAB alone were submitted to parasacral TENS. The inclusion criteria consisted of children with idiopathic OAB alone The Rome III criteria for children of 4-18 years of age were used to diagnose constipation. All the children were treated with 20 sessions of parasacral TENS applied for 20min, three times weekly on alternating days (Figure). No instructions were given to the participants with respect to diet, laxatives, or pharmaceutical treatment for constipation throughout the study period. None of the patients used anticholinergics. Standard urotherapy was prescribed. Parasacral TENS improves OAB and constipation. The presence of constipation before treatment was not associated with a poorer prognosis insofar as the resolution of the symptoms of OAB was concerned. Likewise, there was no association between the resolution of constipation with parasacral TENS and the resolution of OAB. There was no statistically significant difference in urinary symptoms between the constipated and nonconstipated children. There was an improvement in urgency, urge incontinency and in holding maneuvers in both the constipated and non-constipated children; however, there was no significant improvement in enuresis. The resolution of OAB was not associated with the resolution of constipation and vice versa.

The impact of pontine disease on lower urinary tract symptoms in patients with multiple sclerosis.

To investigate the relationship between pontine lesion characteristics on MRI and lower urinary tract symptoms (LUTS) in patients with multiple sclerosis (MS). We performed a prospective cohort study of patients with MS and LUTS who were undergoing brain/spine MRI. Patients were administered the American Urological Association Symptom Score (AUA-SS), Medical, Epidemiologic, and Social Aspects of Aging questionnaire (MESA), and Urogenital Distress Inventory questionnaire (UDI-6), underwent Kurtzke Expanded Disability Status Scale (EDSS) scoring by a neurologist, and had their MRIs reviewed by a neuroradiologist. The relationships between symptom scores and lesion number, size, and location were analyzed. There were 42 patients that completed the study and 20 (48%) had one or more pontine lesions. Total AUA-SS and UDI-6 were related to multiple Short Form Health Survey (SF-36) scales and not EDSS scoring. Weak urinary stream measured on the AUA-SS (P = 0.028), and urgency incontinence measured on the MESA questionnaire (P = 0.034) were related to pontine lesion diameter. There was no difference in urinary symptoms according to the presence or absence of a pontine lesion, or according to lesion location within the pons. Pontine lesion size appears to be related to lower urinary tract symptoms (weak stream and urgency incontinence) in patients with MS. Therefore, CNS lesion characteristics may be able to phenotype voiding symptoms in patients with MS. Neurourol. Urodynam. 36:453-456, 2017. © 2016 Wiley Periodicals, Inc.

Does Combination Therapy with Tamsulosin and Tolterodine Improve Ureteral Stent Discomfort Compared with Tamsulosin Alone? A Double-Blind, Randomized, Controlled Trial

Ureteral stent discomfort is a significant postoperative problem formany patients. Despite the use of narcotics and α-blockers patients often experience bothersome lower urinary tract symptoms and pain, which impair daily activities. We compared combination therapy with an α-blocker and an anticholinergic to monotherapy with an α-blocker. A double-blind, randomized, controlled trial was performed from December 2012 to April 2014. A total of 80 patients were randomized, including 44 to the combination group (tamsulosin 0.4 mg and tolterodine early release 4 mg) and 36 to the monotherapy group (tamsulosin 0.4 mg and placebo). Patients with preexisting ureteral stent placement or current anticholinergic therapy were excluded from study. Patients completed USSQ (Urinary Stent Symptom Questionnaire) before stent placement on the day of surgery, the day after stent placement, the morning of stent removal and the day after stent removal. The questionnaire included questions regarding urinary symptoms, general health, body pain, and work and sexual history. A total of 80 patients (40 males and 40 females) were studied. Mean age was 51.5 vs 51.3 years (p = 0.95) and mean body mass index was 33.6 vs 31.9kg/m(2) (p = 0.44) in monotherapy group 1 vs combination therapy group 2. Betweenthe 2 groups there was no significant difference in urinary symptoms, body pain and activities of daily living from baseline to just before stent removal (p = 0.95, 0.40 and 0.95, respectively). Although there was no difference between the groups, both showed improvement in urinary symptoms from the time ofinitial stent insertion to just prior to stent removal (difference -0.50 for combination therapy and -0.40 for monotherapy). The mean stent indwelling time of 9.6 and 8.7 days in the combination and monotherapy groups, respectively, did not differ (p = 0.67). On ANOVA it had no significant impact on results (p = 0.64). Combination therapy with tamsulosin and tolterodine does not appear to improve urinary symptoms, bodily pain or quality of life in patients after ureteral stent placement for nephrolithiasis compared to tamsulosin alone. Both groups experienced worse urinary symptoms, pain and quality of life with a stent, suggesting that further research is necessary to improve stent discomfort.

Free uroflowmetry for voiding dysfunction measurement in women with pelvic organ prolapse and urinary incontinence in primary care.

Free uroflowmetry for voiding dysfunction measurement in women with pelvic organ prolapse and urinary incontinence in primary care.

1817 DO URETERAL EXTRACTION STRINGS AFFECT POST-OPERATIVE COMPLICATIONS: RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopy or Percutaneous Stone Removal (III)1 Apr 20131817 DO URETERAL EXTRACTION STRINGS AFFECT POST-OPERATIVE COMPLICATIONS: RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL Kerri Barnes, Megan Bing, and Chad Tracy Kerri BarnesKerri Barnes Iowa City, IA More articles by this author , Megan BingMegan Bing Iowa City, IA More articles by this author , and Chad TracyChad Tracy Iowa City, IA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2180AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteral stent extraction strings may improve patient convenience and lower healthcare costs. This study sought to evaluate patient preference for extraction method and determine whether extraction strings are associated with changes in quality of life, pain, or complications. METHODS Patients scheduled for ureteroscopic stone surgery were approached for potential enrollment in this IRB-approved study. Patients were excluded if they had a pre-operative urinary tract infection (UTI), planned bilateral procedure, pregnancy, or a solitary kidney. Patients were randomized to a stent with or without an extraction string at the conclusion of the procedure. Patients with a string removed their stent at home on post-operative day 7 (POD), while those without a string were scheduled for cystoscopic retrieval POD 7-14. Symptoms were evaluated using the validated Ureteric Stent Symptom Questionnaire (USSQ) on POD 1 and 6. All patients completed a Likert pain survey following stent removal. RESULTS To date, 142 consecutive patients have been approached for enrollment. 52 patients did not meet eligibility criteria, while 46 refused to participate. Of those refusing participation, 37% preferred a string, while 63% did not want an extraction string (20% total cohort). Forty-four patients met all inclusion criteria and were randomized. There was no difference between groups in regards to age, laterality, BMI, or sex. There was no difference in stent related complications (p=0.3) or UTI (p=0.78) between those with and without extraction strings. Three patients (14%) with extraction strings had early dislodgement; however, none of these patients required subsequent replacement. Likewise, there was no differences in urinary symptoms, pain, affect on work or change in global quality of life between patients with or without extraction string (p=0.78, 0.59, 0.98, 0.78, respectively). Nineteen patients (34%) called with postoperative questions, with no difference between those with and without strings (p=0.79). CONCLUSIONS Ureteral stent extraction strings following ureteroscopy do not affect patient quality of life, increase postoperative pain or complications. Extraction strings should be used with caution who have imperative indications for stenting as up to 14% of patients may prematurely dislodge their stent. Continued enrollment of patients in the study is needed to determine if there are more subtle differences among groups. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e747 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kerri Barnes Iowa City, IA More articles by this author Megan Bing Iowa City, IA More articles by this author Chad Tracy Iowa City, IA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

A Pilot Clinical Trial of Radioprotective Effects of Curcumin Supplementation in Patients with Prostate Cancer

Background: Patients with prostate cancer who accede to radiation therapy usually experience several side effects and these toxicities are sometimes dose limiting. Some previous in vitro and in vivo studies have proposed a radioprotective role for curcumin, the yellow pigment of turmeric. Objectives: The purpose of this investigation was to assess the radioprotective effects of curcumin supplementation in patients with prostate cancer. Methods: Forty prostate cancer patients undergoing external beam radiotherapy (EBRT) were randomly assigned to curcumin group, taking 3 g/d curcumin (6 × 500 mg capsules of BCM95 n=20), or placebo group (n=20). Quality of life was assessed by the Persian version of the European Organization for Research and Treatment of Cancer prostate cancer-specific quality of life questionnaire (QLQ-PR25).Analysis of covariance was used to compare radiotherapy related symptoms between groups following the intervention, adjusted for baseline symptoms. Results: No differences in urinary symptoms, bowel symptoms, treatment related symptoms and sexual activity were observed between the curcumin and placebo groups before the intervention. The change in urinary symptoms across the 20-week period differed significantly between groups (p=0.011) and patients in the curcumin group experienced much milder urinary symptoms compared with the placebo group. No group differences were observed in any other domain of the QLQ-PR25. Conclusions: Curcumin can confer radioprotective effect in patients with prostate cancer who undergo radiation therapy through reducing the severity of radiotherapy related urinary symptoms. However supplementation with 3 g/ day curcumin could not reduce the severity of bowel symptoms or other treatment related symptoms.

Multi‐length or 24 cm ureteric stent? A multicentre randomised comparison of stent‐related symptoms using a validated questionnaire

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: One of the suggested factors for stent-related symptoms is that excess distal intravesical stent mass may cause bladder irritation. There is a lack of studies investigating this in a randomised controlled fashion using a validated questionnaire. This study compared two of the most commonly used length of stents (a 30 cm multi-length vs a 24 cm long stent) and showed no significance difference in stent-related symptoms in patients with either of these stents. To investigate whether excessive redundant intravesical stent component contributes to the severity of stent-related symptoms in patients with a ureteric stent. We compared stent-related symptoms in patients who had either a standard 24 cm or multi-length ureteric stent. In all, 162 patients with upper urinary tract calculi requiring ureteric stent insertion were randomised to receive either a 6 F × 24 cm Contour(TM) or multi-length 6 F × 22-30 cm Contour VL(TM) stent. Patients were requested to complete the validated Bristol Ureteric Stent Symptom Questionnaire (USSQ) at 1 and 4 weeks after stent insertion and 4 weeks after removal. The mean scores for each domain of the USSQ for both groups were compared using the Student's t-test. Any adverse events, e.g. stent migration, early removal of stent due to stent-related symptoms and failure of stent insertion, were also recorded. In all, 153 patients who had successful stent insertion were requested to complete the USSQ and 74% of patients returned at least the week 1 questionnaire. At 1 and 4 weeks with the stent in situ, comparison of the mean scores showed no significant difference in urinary symptoms, pain, general health, work performance, sexual dysfunction and number of days patients stayed in bed or reduced their routine activities. Three (2%) patients had their stent removed early due to stent-related symptoms and five (3%) had failed stent insertion. This study did not find any difference in symptoms between the 24 cm or multi-length Contour stents. However, the study was not powered to detect small differences particularly for the pain symptom domain. Stents should only be used sparingly and the stent dwell-time should be minimised.

633 A MULTI-CENTRE RANDOMIZED CONTROLLED STUDY TO COMPARE THE IMPACT OF DIFFERENT URETERAL STENT LENGTHS ON PATIENTS' QUALITY OF LIFE USING A VALIDATED QUESTIONNAIRE

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2011633 A MULTI-CENTRE RANDOMIZED CONTROLLED STUDY TO COMPARE THE IMPACT OF DIFFERENT URETERAL STENT LENGTHS ON PATIENTS' QUALITY OF LIFE USING A VALIDATED QUESTIONNAIRE Robert Calvert, Kee Wong, Sudhanshu Chitale, Stuart Irving, Muthuswamy Nagarajan, Chandra Biyani, Anthony Browning, James Young, Anthony Timoney, Francis Keeley, and Neil Burgess Robert CalvertRobert Calvert Liverpool, United Kingdom More articles by this author , Kee WongKee Wong Liverpool, United Kingdom More articles by this author , Sudhanshu ChitaleSudhanshu Chitale Norwich, United Kingdom More articles by this author , Stuart IrvingStuart Irving Norwich, United Kingdom More articles by this author , Muthuswamy NagarajanMuthuswamy Nagarajan Wakefield, United Kingdom More articles by this author , Chandra BiyaniChandra Biyani Wakefield, United Kingdom More articles by this author , Anthony BrowningAnthony Browning Wakefield, United Kingdom More articles by this author , James YoungJames Young Bristol, United Kingdom More articles by this author , Anthony TimoneyAnthony Timoney Bristol, United Kingdom More articles by this author , Francis KeeleyFrancis Keeley Bristol, United Kingdom More articles by this author , and Neil BurgessNeil Burgess Norwich, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1509AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Insertion of ureteral stent is a common urological procedure in both elective and emergency settings. However, indwelling ureteral stent is often associated with significant pain and urinary symptoms. One suggested factor for this is bladder irritation secondary to a long redundant distal end of ureteral stent. The objective of this study is to compare the impact of multi-length 30cm and single length 24cm ureteral stents on patients' quality of life. METHODS 162 patients with upper urinary tract calculi requiring ureteral stent insertion were randomized into group 1 (6Fr x 24cm, Contour™) or group 2 (6Fr x 22–30cm, Contour VL™). Both stents were different in length but were otherwise identical and manufactured by the same company. Patients were requested to complete the validated Bristol ureteric stent symptom questionnaire (USSQ) at 1 and 4 weeks after stent insertion and 4 weeks after removal. Mean scores for each domain of the USSQ in both groups were compared using 2-tailed unpaired t test. Any adverse events such as stent migration, early removal of stent due to stent-related symptoms and failure of stent insertion were also recorded. RESULTS 153 patients who had successful ureteral stent insertion were requested to complete the USSQ. The response rate was 74% (62 and 51 patients in group 1 and 2 respectively). There were no significant difference in both groups in terms of age (p=0.47) or sex (p=0.22). At 1 and 4 weeks with the stent in situ, comparison of the mean domain scores demonstrated no significant difference in urinary symptoms (p=0.42 and p=0.19), pain (p=0.84 and p=0.39) and general health (p=0.48 and p=0.98). This is also similar for work performance (p=0.87 and p=0.78), sexual dysfunction (p=0.71 and p=0.41) and number of days patients stayed in bed (p=0.11 and 0.65) or reduced their routine activities (p=0.10and p=0.63). There were 3 (2%) patients who had stent removed earlier due to severe stent-related symptoms (all from group 1) and 5 (3%) patients with failed stent insertion. There was no ureteral stent migration noted in this study. CONCLUSIONS Based on this study, there is no difference in the impact on quality of life in patients who had either a multi-length or 24cm ContourTM ureteral stent. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e256 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Robert Calvert Liverpool, United Kingdom More articles by this author Kee Wong Liverpool, United Kingdom More articles by this author Sudhanshu Chitale Norwich, United Kingdom More articles by this author Stuart Irving Norwich, United Kingdom More articles by this author Muthuswamy Nagarajan Wakefield, United Kingdom More articles by this author Chandra Biyani Wakefield, United Kingdom More articles by this author Anthony Browning Wakefield, United Kingdom More articles by this author James Young Bristol, United Kingdom More articles by this author Anthony Timoney Bristol, United Kingdom More articles by this author Francis Keeley Bristol, United Kingdom More articles by this author Neil Burgess Norwich, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Preoperative Evaluation of Posterior Deep-Infiltrating Endometriosis Demonstrates a Relationship with Urinary Dysfunction and Parametrial Involvement

Study Objective To estimate the association between urinary symptoms and quality of life in patients with posterior deep-infiltrating endometriosis (DIE) with anatomical locations of endometriosis. Design Prospective nonrandomized study (Canadian Task Force classification II-2). Setting Tertiary care hospital. Patients One hundred fifty-three patients with DIE and 28 control subjects. Interventions Clinical examination completed using transvaginal ultrasonography and magnetic resonance imaging. Measurements and Main Results Urinary symptoms and quality of life were evaluated using the International Prostate Symptom Score (IPSS) and Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaires. There was a higher incidence of urinary symptoms and a high IPSS in patients with posterior DIE compared with the control group. The IPSS questionnaire detected a relation between parametrial endometriosis and voiding symptoms (p = .03), altered quality of life (p = .02), and a high total score (p = 0.04) in patients with posterior DIE. No difference in urinary symptoms and total BFLUTS score was observed between the groups. A relation was found between parametrial endometriosis and urinary symptoms (p = .02), altered quality of life (p = .04), and high total score (p = .03) in patients with posterior DIE. At multivariable analysis, a correlation was found between parametrial endometriosis and IPSS total score (p = .03), IPSS voiding symptoms (p = .04), and IPSS quality of life (p = .009). Similarly, a correlation was found between parametrial endometriosis and BFLUTS symptoms (p = .003), BFLUTS quality of life (p = .003), and BFLUTS total score (p = .007). Conclusion Patients with posterior DIE have a high incidence of urinary symptoms. Moreover, parametrial endometriosis is associated with altered urinary function and should be systematically evaluated in these patients.

Urinary Retention following Prostate Seed Implant Brachytherapy following Rigid Cystoscopy

Purpose/Objective(s): Transperineal ultrasound guided prostate seed brachytherapy (PSI) is a common procedure performed for the long-term control of prostate cancer. After the completion of the procedure, a cystoscopy is often performed to ensure that no seeds were inadvertently introduced into the bladder. After the patient recovers, he is generally given a trial of voiding. If the patient cannot urinate or has significant urinary retention, a Foley catheter is generally replaced, and the patient is sent home with the catheter for 1-2 weeks to allow for a decrease in prostatic edema. Published studies have shown differences in urinary symptoms for patients who underwent rigid versus flexible cystoscopy outside of the setting of PSI. Here, we investigate possible factors including cystoscopy that may contribute to urinary toxicity, the most common form of toxicity in patients receiving PSI.