Ureteral Stent-related Symptoms Research Articles

Comparison of the efficacy and complications of tolterodine and α-adrenergic receptor blockers in improving ureteral stent-related symptoms: A systematic review and meta-analysis.

We conducted a systematic evaluation of the therapeutic efficacy and complications of tolterodine and α-adrenergic receptor blockers in alleviating ureteral stent-related symptoms. Until August 2023, we conducted a comprehensive literature search on PubMed, Embase, Web of Science, and Cochrane Library to identify randomized controlled trials evaluating the efficacy and complications of tolterodine and α-adrenergic receptor blockers in treating ureteral stent-related symptoms. Two reviewers independently screened studies and extracted data. The scores from various domains of the Ureteral Stent Symptom Questionnaire (USSQ) were summarized and compared, and statistical analysis was performed using RevMan 5.4.0 software. A total of 8 studies met the inclusion criteria for our analysis. These studies were conducted at different centers. All studies were randomized controlled trials, involving a total of 487 patients, with 244 patients receiving α-adrenergic receptor blockers and 243 patients receiving tolterodine. The results showed that tolterodine demonstrated significantly better improvement in body pain (MD, 1.56; 95% CI [0.46, 2.66]; p = 0.005) (MD, 0.46; 95% CI [0.12, 0.80]; p = 0.008) (MD, 3.21; 95% CI [1.89, 4.52]; p = 0.00001) among patients after ureteral stent placement compared to α-adrenergic receptor blockers at different time points. Additionally, at 4 weeks, tolterodine showed superior improvement in general health (MD, 0.15; 95% CI [0.03, 0.27]; p = 0.01) and urinary symptoms (MD, 1.62; 95% CI [0.59, 2.66]; p = 0.002) compared to α-adrenergic receptor blockers, while at 6 weeks, tolterodine showed better improvement in work performance (MD, -1.60; 95% CI [-2.73, -0.48]; p = 0.005) compared to α-adrenergic receptor blockers. Additionally, the incidence of dry mouth (RR, 4.21; 95% CI [1.38, 12.87]; p = 0.01) is higher with the use of tolterodine compared to α-adrenergic receptor blockers. However, there were no significant statistical differences between the two drugs in other outcomes. This meta-analysis suggests that tolterodine is superior to α-adrenergic receptor blockers in improving physical pain symptoms after ureteral stent placement, while α-adrenergic receptor blockers are more effective than tolterodine in enhancing work performance. Additionally, the incidence of dry mouth is higher with the use of tolterodine compared to α-adrenergic receptor blockers. However, higher-quality randomized controlled trials are needed to further investigate this issue.

Comparing efficacy and safety of mirabegron, tamsulosin, and solifenacin in ureteral stent-related symptoms: outcomes from a network meta-analysis

Comparing efficacy and safety of mirabegron, tamsulosin, and solifenacin in ureteral stent-related symptoms: outcomes from a network meta-analysis

Ureteral stent related symptoms: A comparative study.

In urology, ureteral stents are used to treat obstructive diseases. Hematuria (54%), fever, discomfort, and lower urinary system symptoms are the predominant symptoms related to ureteral stent. This article links stent symptoms to double-j width and length, as well as patient's height, weight, and body mass index (BMI). Ureteric Stent Symptoms Questionnaire (USSQ) was used to measure ureteral stent symptoms at 1st and 4th week of stent in situ as well as the 4th week after pigtail removal. A 200-patient prospective study, where patients were allocated into four groups following ureteral stent insertion depending on the stent characteristics. Those groups were: 4.8 Fr./26 cm (Group A), 4.8 Fr./28 cm (Group B), 6 Fr/26 cm (Group C), and 6 Fr/28 cm (Group D). Men comprised 53.5% of 200 patients. Participants had an average age of 49 ± 15.5 years, height of 175 ± 8.94 cm, and BMI of 23.8 ± 7.6 cm. The laboratory results were identical between groups. At the first and fourth week, groups had similar urine symptoms, pain severity, health status and occupational activities. The difference in pain location was statistically significant. Group A had 82.4% renal back pain in the first week, whereas Group B had 68.8%, Group C 31.3% and Group D 62.5 (p = 0.04). At the fourth week, 64.7% of Group A patients reported kidney front pain, compared to 100% of Group B, 93.3% of Group C, and 100% of Group D (p = 0.04). There was statistical significance in the sexual activity of the patients. 24.4% of Group C patients stopped sexual activity before stent installation, compared to 10.6%, 8.3%, and 6.4% of the other groups (p = 0.03). A moderate percentage of patients had active sexual activity at week 4 (Group A: 7.8%, Group B: 5.8%, Group C: 8.2%, Group D: 4.1%), p = 0.83. In multivariate analysis, urinary catheter group, age, weight, height, and BMI did not significantly affect urine index score (UIS), pain index score (PIS), general health (GH), quality of work (QW), and quality of sex (QS). Despite various attempts to establish the best ureteral stent, the effect of double-j stent physical features on stent-related symptoms remained unknown. No verdict is conceivable without adequate empirical data.

Factors associated with unplanned clinical encounters for ureteral stent-related symptoms.

Ureteral stent-related symptoms (USRS) often result in unplanned phone calls and ER visits. We hypothesize that patient factors can be identified to predict these unplanned encounters. Retrospective analysis of indwelling ureteral stent placements from 2014 to 2019 at a single institution by CPT code was performed. Patient demographics, discharge medications, and clinical factors were evaluated using multiple logistic regression with respect to postoperative telephone and emergency room (ER) encounters for USRS. Of 374 patients, 75 (20.1%) had one or more encounters for USRS: 48 (12.8%) called the clinic and 39 (10.4%) returned to the ER. Chronic opioid use was predictive of calls to clinic and ER visits (OR 3.21 [CI 1.42-6.97], p < 0.01 and OR 3.64 [CI 1.45-8.98], p < 0.01). Survival analysis stratified by history of chronic opioid use and discharge opioid prescriptions demonstrated that opioid naïve patients receiving opioids at discharge had unplanned encounters sooner and more often [Calls p = 0.025, ER p = 0.041]), whereas patients with chronic opioid usereturned to the ER sooner and more frequently when prescribed additional opioids (Calls p = 0.4, ER p = 0.002). Patients with a history of chronic opioid use may experience more intense USRS or have a lower threshold to seek medical care than opioid naïve patients and tend to bypass calling the clinic for the ER. Given that none of the studied medications reduced unplanned patient contact for USRS, urologists should consider upfront definitive management of urinary obstruction when appropriate.

COMPARISON OF PHARMACOLOGY AGENTS EFFECT IN TREATING URETERAL STENT RELATED SYMPTOMS: SYSTEMATIC REVIEW &amp; META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL¬

Objective: We wish to update existing meta-analyses to assess the effectiveness of pharmacological agents against ureteral stent-related symptoms with better design of RCTs, as well as more valid and reliable measurement methods. Material &amp; Methods: Relevant published articles up to February 2022 were obtained from PubMed, CENTRAL, Google Scholar, Science Direct, and DOAJ. All single-blind or double-blind RCTs with various comparisons using pharmacological agents and/or placebo in patients with ureteral stent-related symptoms, with outcome assessment using USSQ at week 1 and week 4 during stent placement was included in the study. Statistical parameter Mean Difference (MD) with 95% CI was used to measure effect size. The p value less than 0.05 indicates statistical significance. Results: Alpha blockers (2 studies, 85 samples) significantly reduced fourth week UIS compared to placebo (MD: – 5.46, 95% CI: – 7.47 to -3.46, I2 = 0%, P = &lt; 0.001), and alpha blockers (2 studies, 42 samples) significantly reduced first week SIS compared to combination therapy (MD: – 0.82, 95% CI: – 1.56 to – 0.08, I2 = 0%, P = 0.03). The results of the meta-analysis of USSQ scores in other domains have no significant differences. Conclusion: Alpha blockers were better than placebo in reducing UIS due to ureteral stent in the fourth week of stent placement, and better than combination therapy in reducing SIS due to ureteral stent in the first-week post stenting. However, more RCTs are needed with larger samples and better designs to reach valid conclusions.&#x0D; Keywords: Stents, Randomized Controlled Trials as Topic, Single-Blind Method.

Efficacy of Pregabalin, Solifenacin, or Combination Therapy for Ureteral Stent Related Symptoms: A Systematic Review and Meta-Analysis

Objective: The Double-J (DJ) ureteral stent is essential in urology but can lead to Ureteral Stent-Related Symptoms (USRS), prompting research into various therapies to enhance patient comfort. The purpose of this study is to assess the efficacy of pregabalin, solifenacin, or combined therapy on ureteral stent-related symptoms. Materials and Methods: We conducted thorough searches in four databases, which included PubMed, Cochrane, EBSCO, and ProQuest. PRISMA Guideline 2020 was applied in this study. The risk of bias was assessed using Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0. Results: Ten studies consisting of 1477 participants were included in this study. Solifenacin monotherapy could significantly decrease total USSQ (mean difference (MD) -16.62; p=0.001), urinary symptoms (MD -9.16; p=0.002), and sexual matters (MD -0.81; p=0.002). Pregabalin monotherapy could significantly decrease pain (MD -7.29; p&lt;0.00001). Compared to solifenacin monotherapy, combination therapy of pregabalin and solifenacin could significantly decrease total USSQ (MD -12.40; p &lt;0.0001), urinary symptoms (MD -1.88; p=0.007), pain (MD -6.82; p&lt;0.00001), sexual matters (MD -0.77; p &lt;0.00001), and additional problems (MD -1.51; p=0.0007). Conclusion: Combination therapy of pregabalin and solifenacin had the best advantages in lowering USRS, especially urinary symptoms, pain, sexual matters, and some other additional problems.

Alfuzosin vs. Silodosin in the Improvement of Ureteral Stent-Related Symptoms after Endoscopic Surgical Treatment of Urolithiasis: A Retrospective Comparison

Purpose In this study, we aimed to compare the efficacy of two α-blockers, alfuzosin and silodosin, which have different pharmacological properties despite being uroselective, in the treatment of double-J stent (DJS)-related symptoms. Methodology Fifty-six male patients who underwent DJS implantation and for whom all data were available were included in the study. All patients were asked to complete the validated Turkish version of the Ureteral Stent Symptom Questionnaire (USSQ), international prostate symptom score (IPSS), and international index of erectile function-5 (IIEF-5) the day before stent removal and again one month after stent removal. Statistical analysis of these variables was performed in the groups, and a value of p&lt;0.05 was considered statistically significant. Results Significant decreases in IPSS, IPSS-quality of life, and USSQ scores were observed in both Group A and Group S one month after stent removal compared with before stent removal (p&lt;0.05). Whereas no side effects were observed in the alfuzosin group (Group A), retrograde ejaculation was observed in 8 (25.2%) patients in the silodosin group (Group S) (p=0.006). Furthermore, a statistically significant increase in IIEF-5 score was observed in both groups after stent removal compared with IIEF-5 score with stenting (p&lt;0.05). Conclusion The DJS has a significant impact on patients’ quality of life and should only be used when indicated, not routinely after every endoscopic stone procedure. Considering that silodosin may cause more ejaculation problems than alfuzosin, we believe that both drugs can be used in male patients to resolve DJS-related symptoms.

Ureteral Stent-Related Symptoms and Pharmacotherapy: A Brief Narrative Review.

The purpose of this article is to review the effects of different types of pharmacotherapy on symptoms that affect the quality of a patient's life after stent insertion. A thorough Medline/PubMed nonsystematic review was conducted from 1987 to January 2023, using the terms: "pigtail" OR "ureteral stents" AND "lower urinary tracts symptoms" OR "LUTS" AND "pharmacotherapy" OR "drugs". Relevant studies conducted in humans and reported in English language were included. The available reviews and articles associating the use of drugs with stent-related symptoms (SRS) provide conflicting results. Most of them show a clear benefit of alpha blockers, particularly alfuzosin, on treating urinary SRS, and hence there is a strong recommendation for the use of alpha blockers for the treatment of SRS in the guidelines of the European Association of Urology. Anticholinergics and mirabegron have shown a significant benefit in dealing with irritative bladder symptoms. In contrast, the findings for combination therapies are contradictory, with some studies showing that combination therapy is no superior to monotherapy with regards to most of the subsets of the Ureteral Stent Symptom Questionnaire (USSQ), whereas others present a clear benefit of combination therapies, specifically silodosin and solifenacin, in treating stent-associated lower urinary tract symptoms (LUTS), in comparison with any other type of monotherapy or combination therapy. Many studies suggest that some categories of pharmacotherapy, such as alpha blockers, can alleviate SRS. However, there is conflicting evidence concerning most other types of medical treatment. Randomized trials with the largest number of patients are needed to investigate the effectiveness of novel approaches on SRS.

The effect of intravesical stent length and Propiverine on ureteral stent related symptoms - Prospective controlled trial

Objective: Ureteral double J stents are widely utilized in urolithiasis. Disturbing stent-related symptoms may occur while the stent is in location. Various medical agents and stent-related solutions were examined for this problem. However, a definite drug has still not been found. We aimed to research the effect of propiverine on stent-related symptoms.Material and Methods: Patients who underwent ureteroscopic stone surgery between June 2020 and May 2022 were included in the study. While the control group was untreated, the treatment group received 45 mg of propiverine daily after 1 week of the operation. Stent-related symptoms were assessed by ureteral stent symptom questionnaire (USSQ) at the end of 1st week and 3rd week of surgery. In addition, the intravesical stent parts of all patients were quantitatively measured with a ruler during stent removal at the end of 3 weeks.Results: A total of 177 patients were assessed in the study. Eighty-seven patients were control and 90 patients of them were treatment group. According to USSQ, urinary symptoms scores, body pain scores, general health scores, work performance scores, sexual health scores, additional problem scores, and global quality of life (QoL) scores were found to decrease in the treatment group (p&amp;lt;0.001 All domains). Intravesical stent length was found positive correlation with the urinary symptom score (1st week) of all patients.Conclusion: Stent-related symptoms are more likely in patients with longer intravesical stent length. Propiverine successfully relieves stent-related symptoms.

SC148 - Are ureteral stent-related symptoms detectable in transplanted patients? milder, but they are. Results from a prospective observational cohort study

SC148 - Are ureteral stent-related symptoms detectable in transplanted patients? milder, but they are. Results from a prospective observational cohort study

Distal end of Double-J ureteral stent position on ureteral stent-related symptoms: A systematic review and meta-analysis.

BackgroundMost patients suffer from ureteral stent-related symptoms (USRS) caused by indwelling ureteral stents. Nevertheless, various medications to alleviate discomfort as well as novel stents are continually being developed, and in recent years, some researchers have believed that proper intravesical stent placement can relieve USRS.ObjectiveTo determine appropriate intravesical ureteral stent position may alleviate USRS.MethodsUp to May 1, 2022, the PubMed, Embase, Scopus and Web of Science databases were thoroughly searched, and two independent reviewers included relevant studies that met the PICO (Patient, Intervention, Comparison, Outcome) criteria. Studies methodological quality were assessed by ROB2 and ROBINS-I. Ureteral stent symptom questionnaire (USSQ), international prostate symptom score (IPSS) and quality of life (QoL) was used to quantify the USRS. According to intravesical ureteral stent position, Group A was defined as the contralateral group, that is distal end of ureteral stent crossed the bladder midline, whereas Group B was classified as ipsilateral group, meaning stent end did not cross the midline.ResultsSix studies incorporating a total of 590 patients were eligible. In terms of USSQ score, the meta-analysis showed that contralateral group was associated with a significant increase in USSQ total (MD, 17.55; 95% CI, 12.04 to 23.07; P < 0.001), urinary symptoms (MD, 2.74; 95% CI, 0.48 to 5.01; P = 0.02), general health (MD, 4.04; 95% CI, 2.66 to 5.42; P < 0.001), work performance (MD, 1.36; 95% CI, 0.75 to 1.98; P < 0.001) and additional problems (MD, 0.89; 95% CI, 0.47 to 1.32; P < 0.001) scores while not associated with a significant increase in body pain (MD, 3.13; 95% CI, −0.19 to 6.44; P = 0.06) and sexual matters (MD, 1.01; 95% CI, −0.03 to 2.06; P = 0.06). As for IPSS, although no significant differences in IPSS total (MD, 2.65; 95% CI, −0.24 to 5.54; P = 0.07) or voiding symptoms (MD, −0.84; 95% CI, −3.16 to 1.48; P = 0.48) scores were found, ipsilateral group was associated with a significant decrease in storage symptoms (MD, 1.92; 95% CI, 0.91 to 2.93; P = 0.0002). Furthermore, ipsilateral group was linked to a significant decrease in QoL score (MD, 1.00; 95% CI, 0.18 to 1.82; P = 0.02).ConclusionThis meta-analysis proven that correct intravesical stent position was critical, and patients with stents crossing the midline experienced more severe USRS than those who did not. Further high-quality randomized controlled trials are needed to corroborate our findings.

Mirabegron vs. solifenacin in control of endoscopically inserted ureteral stent-related symptoms.

We aimed to assess the efficacy and safety of Mirabegron vs. solifenacin to treat LUTS resulting from DJ-stent insertion. A total of 97 patients who had DJ-stent inserted for urinary stone disease were randomly divided into three groups according to received treatment. Group A took Mirabegron 50mg daily, group B took solifenacin 5mg daily from the 4th day after stent placement until the stent was removed, and group C only was hydrated well. All patients were evaluated by USSQ and IPSS at 4th day post-insertion of ureteral stent, follow-up day before removing of stent and post-removal of stent. The USSQ urinary symptom scores at day 4 comparing to day of removal of stent showed significant difference in between study groups (32 ± 6-13 ± 6 vs. 31 ± 6-14 ± 4 in Mirabegron and solifenacin, respectively) and without significant difference in control group. The USSQ body pain score significantly decreased in both Mirabegron and solifenacin groups at day of stent removal comparing to day 4 post-insertion of DJ with insignificant decreasing in the control group. Quality of life scores showed significant improving in Mirabegron and solifenacin group, and there was no difference in control group at 4 and 14days after treatment. No severe complications were observed in either group. In our series, we indicate that Mirabegron and solifenacin can be used to improve symptoms caused by the insertion of DJ-stent without significant difference.

Comparison of ureteral stent diameters on ureteral stent-related symptoms: A systematic review and meta-analysis.

Ureteral stents may induce complications that may disrupt the quality of life of patients. Several factors that may cause these symptoms are the design, material, diameter, length, and position of the stent. The impact of its diameter varies among current reports, thus we aimed to compare the symptoms between 6 Fr and 5 Fr or less ureteral stents. A systematic search and screening were performed in the Embase, Medline, and Scopus databases. Eligible studies included randomized controlled trials (RCTs). Cochrane risk of bias tool 2 was used to evaluate the studies. Seven RCTs were included in this review. Urinary symptoms were discussed qualitatively. From the included studies, the use of a relatively smaller stent diameter yielded an overall lower rate of Ureteral Stent Symptom Questionnaire score and urinary symptoms compared to a stent with a larger diameter. There was no significant difference in migration rate (OR: 1.55, 95% CI: 0.67-3.57, P ¼ .31), visual analogue scale (MD: 0.42, 95% CI: 2.04 to 1.20, P ¼ .61), analgesic use duration (MD: 0.06, 95% CI: 1.02 to 0.91, P ¼ .91), and stone-free rate probability (OR: 1.29, 95% CI: 0.48-3.45, P ¼ .62) between patients with 5 Fr or less and 6 Fr ureteral stents. Smaller ureteral stent size is suggested for reducing ureteral stent-related symptoms, without significant differences in the incidence of stent migration, pain, analgesic use, and stone-free rate.

Mirabegron as effective as oxybutynin for ureteral stent symptoms

Ureteral stents usually cause pain and lower urinary tract discomfort. This study aimed to compare the effect of mirabegron with oxybutynin in relieving ureteral stent-related symptoms over time. A prospective, longitudinal, randomized, single-blinded study was conducted. Patients who had a ureteral stent inserted after urolithiasis treatment were classified into two groups and received either oxybutynin 5 mg/day (Group O) or mirabegron 50 mg/day (Group M). The Ureteral Stent Symptoms Questionnaire (USSQ) was applied on the 3rd, 6th, and 15th postoperative days. Group domain scores were compared, and a mixed linear model was used to better assess score differences. Ureteral Stent Symptoms Questionnaire scores were similar in both groups during all three postoperative days (p>0.05). A longitudinal analysis showed that global quality of life and general health improved over time, independently of the use of any of the medications (p<0.05), while urinary symptoms and body pain scores were lower over time in participants receiving oxybutynin. Both mirabegron and oxybutynin are equivalent in relieving ureteral stent symptoms. Moreover, some stent symptoms seem to decrease over time despite the use of medication.

The Effectiveness Between Tamsulosin and Solifenacin Combined with Tamsulosin on Treatment of Ureteral Stent-Related Symptoms

Introduction: The clinical usage of the ureteral stent caused several stent-related symptoms (SRSs), including lower urinary tract symptoms, pain, general health, work performance, sexual matter and additional problems. This study aims to evaluate the effectiveness between tamsulosin and solifenacin combined with tamsulosin for SRSs.Methods: This double blind randomized controlled trial used 50 patients. Between September 2020 and February 2021, patients underwent double-J stenting after retrograde ureteroscopy were analyzed. All patients would be randomized in a 1:1 ratio in a 1:1 ratio to receive either tamsulosin 0,4 mg (Group A: 25 participants) or tamsulosin 0,4 mg &amp; solifenacin 5 mg combination (group B: 25 participants).We used the Ureteral Symptoms Score Questionnaire (USSQ) as an outcome measure at 1s, 2nd, 3rd and 4th weeks after stent insertion. Results: Group A was found more in women, while in group B was more in men. The highest age in group A and group B was 50-60 years old (36% and 64%). The location of stenting in group A was found more in left (60%), while the group B in the right (52%). Both groups had more patients who were normal nutritional status (60%). There was an improvement in pain and work performance after treatment in both groups, meanwhile group B showed better improvement than group A at all weeks. in addition, there was an improvement in urinary symptoms and sexual matter in group B better than in group A at 2nd to 4th week. Furthermore, group B showed better improvement in general health and additional problem only at 4th week. Conclusions: Combination therapy with tamsulosin and solifenacin improved USSQ score more than the monotherapy group. This implied that combination therapy is optimal for improving SRSs.

The efficacy and safety of mirabegron in treating ureteral stent-related symptoms: A systematic review and meta-analysis.

This meta-analysis aimed to assess the efficacy and safety of mirabegron in treating ureteral stent-related symptoms. MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched to identify randomized controlled trials (RCT) of mirabegron in treating ureteral stent-related symptoms. We conducted a systematic review and meta-analysis based on the eligible RCT. Five RCT including 546 patients and comparing mirabegron with placebo or blank control were involved in the present research. Regarding efficacy, mirabegron was superior to controls in urinary symptom score (P=.0006) and general health score (P < .0001) of the Ureteral Stent Symptom Questionnaire, total International Prostate Symptom Score (P < .00001), quality of life (P < .0001), analgesic use (P=.008), and readmission or visit to hospital due to discomfort (P=.001). Safety assessments including adverse events (P=.40) suggested that mirabegron was well tolerated. The present meta-analysis shows that mirabegron is an effective and safe treatment for relieving ureteral stent-related symptoms with a low occurrence of adverse events.

P0215 - Randomized, prospective study to compare the efficacy and safety of complete intraureteral stent placement versus conventional stent placement in relieving ureteral stent related symptoms

P0215 - Randomized, prospective study to compare the efficacy and safety of complete intraureteral stent placement versus conventional stent placement in relieving ureteral stent related symptoms

A meta-analysis of efficacy and safety of PDE5 inhibitors in the treatment of ureteral stent-related symptoms.

In recent years, phosphodiesterase type 5 (PDE5) inhibitors have been proposed for relieving the ureteral stent-related symptoms. We conducted a meta-analysis to assess the efficacy and safety of PDE5 inhibitors in the treatment of ureteral stent-related symptoms. Randomized controlled trials (RCTs) that reported on the effectiveness of PDE5 inhibitors on ureteral stent-related symptoms were identified and collected from Medline, Embase, and Cochrane Library databases. Four RCTs involving 352 patients were included. Following treatment with PDE5 inhibitors for 1 week, significant improvement of urinary symptoms (P<0.00001) and sexual health (P=0.04) was observed in the PDE5 inhibitors group. After 3 weeks, we found that PDE5 inhibitors were effective in relieving urinary symptoms [mean difference (MD): -11.94, 95% confidence interval (CI): -22.58 to -1.3, P=0.03], body pain (MD: -5.38, 95% CI: -9.35 to -1.41, P=0.008), and improving sexual health (MD: -4.13, 95% CI: -5.07 to -3.19, P<0.00001), general health (MD: -3.92, 95% CI: -5.76 to -2.08, P<0.0001), and additional health (MD: -2.21, 95% CI: -4.03 to -0.40, P=0.02). With regards to work performance (MD: -2.25, 95% CI: -5.13 to -0.62, P=0.12), no significant differences were observed between the PDE5 inhibitors group and the placebo group. In terms of safety, there were no significant differences between these two groups in the incidence of gastrointestinal [odds ratio (OR): 1.25, 95% CI: 0.51 to 3.04, P=0.63], or respiratory (OR: 1.48, 95% CI: 0.50 to 4.44, P=0.48) complications. PDE5 inhibitors were effective in relieving symptoms of patients undergoing ureteral stent placement, and do not increase the risk of complications.

Effect of Empowering Education on Refined Nursing of Patients with Internal Double J Tubes after Surgery for Ureteral Stricture

Objective: To investigate the effect of the theory of enabling education on the fine management of patients with internal double J tubes after ureteral stricture. Methods: Eighty patients with built-in double J tubes after ureteral stricture were selected from the urology department of a grade a hospital in Guangzhou. The patients were divided into control group and observation group by random number method, with 40 patients in each group. The control group received refined nursing after surgery, while the observation group received refined nursing including the theory of empowerment education after surgery on the basis of the control group. Results: After the intervention, the observation group had a higher standard rate of quality indicators, higher self-efficacy score than the control group (P ≤ 0.05), lower scores of ureteral stent-related symptoms, urinary system symptoms, pain symptoms, total health status, job performance, additional problems and total scores than the control group (P ≤ 0.05), and statistically significant differences were found in the total health status dimension and total scores (P ≤ 0.01). The nursing satisfaction survey, the scores of clinical nursing, health education, psychological counseling and nurse-patient communication were all higher than those in the control group (P ≤ 0.05), and the differences in health education and nurse-patient communication were statistically significant (P ≤ 0.01). Conclusion: The theory of enabling education can improve patients’ self-nursing level, promote the implementation of refined nursing quantitative indicators and nursing measures, relieve the poor symptoms of ureteral stricture patients, and improve patients’ satisfaction with nursing work.

Effect of Ureteral Stent Length and Position of Stent Coil in Bladder on Stent-Related Symptoms and Quality of Life of Patients.

Introduction: Various standardized questionnaires can evaluate ureteral stent-related symptoms. The present study utilized a validated instrument, Ureteral Stent Symptoms Questionnaire (USSQ), to know the impact of the length of double J stent (DJS) in comparison to ureter length on patients and their quality of living.Materials and Method: This study is a prospective clinical study conducted in the Department of Urology at a tertiary care center in South India. Patients who underwent DJS after endoscopic ureteral lithotripsy were included in the study. On a computerized tomography scan, the ureteral to stent length ratio (USR) was calculated. USSQ scores at the time of DJS removal and two weeks thereafter were recorded. The distal coil of the stent in the bladder was recorded as grade 1 - not crossing the midline and grade 2 - crossing the midline. Different symptom scores were compared between both grades of bladder coil and for USR of all the patients.Result: A total of 157 patients were included in the study. Over 46 (29.3%) patients had grade-1 and 111 (70.7%) had grade-2 bladder coil. Totally 93 (59.23%) patients reported pain, while 64 (40.77%) patients had no pain. Grade-2 coil patients had more pain than grade 1 (P=0.01). There was a weak inverse relationship between the USR and urinary symptom (P=0.004), pain symptom (P=0.04), and quality of work (P=0.005).Conclusion: Stent length or position of the intravesical stent coil does not appear to affect the quality of life except for the pain. Hence, choosing stent length according to ureteral length seems to have a minimal role in decreasing stent-related morbidity.