Ureteral Stent Symptom Questionnaire Research Articles

A randomized trial investigating clinical outcomes and stent-related symptoms after placement of a complete intra-ureteric stent on a string versus conventional stent placement.

To compare stent-related symptoms (SRS) associated with conventional ureteric JJ stent (CUS) placement and SRS associated with placement of a modified complete intra-ureteric stent (CIUS) with extraction suture, designed to minimize SRS, using the validated Ureteral Stent Symptom Questionnaire (USSQ). We randomized 124 patients who had undergone uncomplicated ureteroscopic lithotripsy into a CIUS and a CUS placement group. USSQ scores were evaluated on postoperative days 1 and 7 (just before stent removal) and 4 weeks after stent removal (control values). Pain scores on a visual analogue scale (VAS) after stent removal were also recorded. Subdomain analysis of all SRS and stent-related complications were also compared. No significant intergroup differences were found in the domain scores for urinary symptoms (P = 0.74), pain (P = 0.32), general health (P = 0.27), work (P = 0.24), or additional problems (P = 0.29). However, a statistically significant difference was noted in VAS scores (P = 0.015). Analysis of subdomains of USSQ item scores showed the CIUS group had significantly better scores for urge incontinence (1.21 vs 1.00; P ≤ 0.001), discomfort on voiding (2.07 vs 1.50; P ≤ 0.001), difficulties with respect to light physical activity (1.131 vs 1.00; P ≤ 0.001), fatigue (1.84 vs 1.57; P = 0.002), feeling comfortable (3.68 vs 3.16; P = 0.003), need for extra help (1.96 vs 1.00; P ≤ 0.001), and change in duration of work (4.27 vs 1.86; P ≤ 0.001). However, the patients in the CIUS group were sexually inactive for the time during which the stent was indwelling (mean: 7.34 days). There was no difference in complication rates between the two groups. The use of a CIUS with strings after Ureteroscopy decreases SRS.

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.

Impact of differential ureteral stent diameters on clinical outcomes after ureteroscopy intracorporeal lithotripsy: A systematic review and meta-analysis.

In this meta-analysis we assessed whether the diameter of ureteral stents (4.7-5-Fr, 6-Fr) has an impact on the rate of occurrence of urinary tract symptoms and complications after successful URS and intracorporeal lithotripsy. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A rigorous search for relevant studies published in MEDLINE, Embase, and the Cochrane Controlled Trials Register was conducted to find informative randomized controlled trials. The reference lists of relevant articles were also manually searched and reviewed. The protocol was prospectively registered at PROSPERO (CRD42020202164). All statistical evaluations were performed using RevMan software version 5.3.0. Seven articles comprising 547 patients were included in the meta-analysis. After placement of ureteral stents with different diameters for approximately 1week, we found that ureteral stents with smaller diameters (4.7-5-Fr) were associated with significant improvements in the main domain scores on the Ureteral Stent Symptom Questionnaire, such as urinary symptoms (mean difference -4.47, 95% confidence interval -5.87 to -3.08; P<0.00001) and body pain (mean difference -2.48, 95% confidence interval -4.37 to -0.59; P=0.01), but poor outcomes in stent migration compared to ureteral stents with a 6-Fr diameter (odds ratio 3.00, 95% confidence interval 1.06-8.51; P=0.04). However, there were no significant differences in Ureteral Stent Symptom Questionnaire scores with regard to work performance (mean difference -0.56, 95% confidence interval -2.52 to 1.40; P=0.58), general health (mean difference -2.29, 95% confidence interval -4.95 to 0.37; P=0.09), additional problems (mean difference -0.43, 95% confidence interval -1.02 to 0.15; P=0.15), and complications such as fever (odds ratio 0.75, 95% confidence interval 0.24-2.39; P=0.63). Ureteral stents with a diameter of 4.7-5-Fr have better outcomes than those with a diameter of 6-Fr, based on the Ureteral Stent Symptom Questionnaire pain and urinary tract symptoms scores. However, they are more prone to migration compared to those with a larger diameter.

A randomized prospective study: assessment of transient ureteral stenting by mono-J insertion after primary URS and stone extraction (FaST 3)

To compare the outcome of a short-term insertion of a mono-J catheter for 6 h following ureteroscopic stone removal to a conventional double-J catheter. This single-center academic study (Fast Track Stent study 3) evaluated stenting in 108 patients with urinary calculi after ureterorenoscopy. Patients were prospectively randomized into two study arms before primary ureterorenoscopy: (1) mono-J insertion for 6 h after ureterorenoscopy and (2) double-J insertion for 3–5 days after ureterorenoscopy. Study endpoints were stent-related symptoms assessed by an ureteral stent symptom questionnaire (USSQ) and reintervention rates. Stone sizes and location, age, operation duration, BMI, and gender were recorded. Of 67 patients undergoing ureterorenoscopy, 36 patients were analyzed in the double-J arm and 31 patients in the mono-J arm. Mean operation time was 27.5 ± 1.3 min versus 24.0 ± 1.3 min, and stone size was 5.2 mm versus 4.5 mm for mono-J versus double-J, respectively (p = 0.06 and p = 0.15). FaST 3 was terminated early due to a high reintervention rate of 35.5% for the mono-J group and 16.7% for the double-J group (p = 0.27). One day after ureterorenoscopy, USSQ scores were similar between the study arms (Urinary Index: p = 0.09; Pain Index: p = 0.67). However, after 3–5 weeks, the Pain Index was significantly lower in those patients who had a double-J inserted after ureterorenoscopy (p = 0.04). Short-term insertion of mono-J post-ureterorenoscopy results in similar micturition symptoms and pain one day after ureterorenoscopy compared to double-J insertion. The reintervention rate was non-significant between the treatment groups most likely due to the early termination of the study (p = 0.27). Ethics approval/Trail Registration: No. 18-6435, 2018

Magnetic double-J stent: Evaluation of tolerance and impact on quality of life compared to traditional double-J stent

IntroductionThe placement of a ureteral stent is one of the most widely performed procedures in urology. It can have a negative impact on the patients’ quality of life, requiring a cystoscopy for its removal. The objective of this study is to evaluate the symptoms and impact on quality of life derived from the use of a magnetic double-J stent (Black Star®) and compare them to those presented in patients with a traditional double-J stent (OptiMed®). Material and methodsWe conducted a comparative, prospective, randomized study in 46 patients who underwent ureterorenoscopy with double-J stent placement between August 2019 and June 2020. Of all patients included, 23 had a traditional double-J stent placed (group A) and 23 had a magnetic double-J stent (group B) placed. We evaluated the results of the Ureteral Stent Symptom Questionnaire (USSQ) in both groups, assessed the technical difficulty related to stent removal and the pain during the procedure using the Visual Analogue Scale (VAS). We also reviewed the need for medical attention due to problems related to the stent or after its removal. ResultsThere were no statistically significant differences between groups regarding the answers in the USSQ and the complications related to the use of the stent. Group B showed less pain (1.52 vs. 4, VAS, p = 0.001) and less difficulty during removal (1.61 vs. 3, p < 0.001) associated with a shorter procedure duration (11.65 min vs. 22.17 min p < 0.001). ConclusionsThe tolerance shown by the use of magnetic double-J is comparable to the tolerance of traditional stent, since it does not cause an increase in urinary symptoms nor worsens the quality of life of patients during its use.

Pigtail Suture Stents Significantly Reduce Stent-related Symptoms Compared to Conventional Double J Stents: A Prospective Randomized Trial

BackgroundDouble J (DJ) ureteral stents are commonly inserted after ureteroscopy (URS) procedures for stone treatment. However, stent-related symptoms are still a major issue. ObjectiveTo determine whether a commercially available pigtail suture stent (PSS) can reduce stent-related symptoms compared to a conventional DJ stent after uncomplicated URS. Design, setting, and participantsWe designed a randomized, single-blind, parallel-group trial from January to November 2020. The inclusion criteria were stone-free URS without intraprocedural complications. Patients with distal ureteral stones were excluded. InterventionInsertion of a PSS or DJ stent after URS. Outcome measurements and statistical analysisThe primary endpoint was the Urinary Symptom Index score on the Ureteral Stent Symptoms Questionnaire (USSQ) 2 wk after URS. Secondary endpoints were USSQ domain scores and responses to individual USSQ questions at 2 d and 2 wk after surgery. Results and limitationsA total of 78 patients were randomized and treated according to protocol. The Urinary Symptom Index score (p = 0.004), overall Visual Analogue Scale (VAS) score (p = 0.022), and the percentage of patients complaining of pain (63.9% vs 86.1%, p = 0.029) were significantly in favor of PSS at both 2 d and 2 wk after URS. At 2 d, the VAS score among patients with pain (p = 0.025) and the General Health Index score (p = 0.036) were significantly better in the PSS group. No severe complications occurred in either group. Study limitations are the exclusion of patients with distal ureteral stones and the limited sample size. ConclusionsPSS significantly reduced stent-related symptoms after URS, in particular urinary symptoms and pain, compared to conventional DJ stents, and showed a good safety profile. Patient summaryStents are hollow tubes placed in the passage between the kidney and the bladder (ureter). The standard stent has two coiled ends (double J stent) to keep it in place in both the kidney and the bladder. We tested a commercial stent with two strings at the bladder end (pigtail suture stent) after procedures to remove stones from the upper urinary tract and found that it caused less stent-related symptoms compared to a double J stent.This trial is registered at Clinicaltrials.gov as NCT03344120.

SKOPE-Study of Ketorolac vs Opioid for Pain after Endoscopy: A Double-Blinded Randomized Control Trial in Patients Undergoing Ureteroscopy.

Pain is the leading cause of unplanned emergency department visits and readmissions after ureteroscopy, making postoperative analgesic stewardship a priority given the current opioid epidemic. We conducted a double-blinded, randomized controlled trial, with noninferiority design, comparing nonsteroidal anti-inflammatory drugs to opiates for postoperative pain control in patients undergoing ureteroscopy for urolithiasis. Patients were randomized and blinded to either oxycodone (5 mg) or ketorolac (10 mg), taken as needed, with 3 nonblinded oxycodone rescue pills for breakthrough pain. Primary study outcome was visual analogue scale pain score on postoperative days 1-5. Secondary outcomes included medication utilization, side effects, and Ureteral Stent Symptom Questionnaire scores. A total of 81 patients were included (43 oxycodone, 38 ketorolac). The 2 groups had comparable patient, stone, and perioperative characteristics. No differences were found in postoperative pain scores, study medication or rescue pill usage, or side effects. Higher maximum pain scores on days 1-5 (p <0.05) and higher questionnaire score (28.1 vs 21.7, p=0.045) correlated with analgesic usage, irrespective of treatment group. Patients receiving ketorolac reported significantly fewer days confined to bed (mean±SD 1.3±1.3 vs 2.3±2.6, p=0.02). There was no difference in unscheduled postoperative physician encounters. This is the first double-blinded randomized controlled trial comparing nonsteroidal anti-inflammatory drugs and opiates post-ureteroscopy, and demonstrates noninferiority of nonsteroidal anti-inflammatory drugs in pain control with similar efficacy, safety profile, physician contact and notably, earlier convalescence compared to the opioid group. This provides strong evidence against routine opioid use post-ureteroscopy, justifying continued investigation into reducing postoperative opiate prescriptions.

Catéter doble J magnético: evaluación de la tolerancia e impacto en la calidad de vida en comparación con el catéter doble J tradicional

IntroductionThe placement of a ureteral stent is one of the most widely performed procedures in urology. It can have a negative impact on the patients’ quality of life, requiring a cystoscopy for its removal. The objective of this study is to evaluate the symptoms and impact on quality of life derived from the use of a magnetic double-J stent (Black Star ®) and compare them to those presented in patients with a traditional double-J stent (OptiMed®). Material and methodsWe conducted a comparative, prospective, randomized study in 46 patients who underwent ureterorenoscopy with double-J stent placement between August 2019 and June 2020. Of all patients included, 23 had a traditional double-J stent placed (group A) and 23 had a magnetic double-J stent (group B) placed. We evaluated the results of the Ureteral Stent Symptom Questionnaire (USSQ) in both groups, assessed the technical difficulty related to stent removal and the pain during the procedure using the Visual Analogue Scale (VAS). We also reviewed the need for medical attention due to problems related to the stent or after its removal. ResultsThere were no statistically significant differences between groups regarding the answers in the USSQ and the complications related to the use of the stent. Group B showed less pain (1,52 vs. 4, VAS, p = 0.001) and less difficulty during removal (1,61 vs. 3, p < 0,001) associated with a shorter procedure duration (11,65 min vs. 22,17 min p < 0,001). ConclusionsThe tolerance shown by the use of magnetic double-J is comparable to the tolerance of traditional stent, since it does not cause an increase in urinary symptoms nor worsens the quality of life of patients during its use.

The role of mirabegron in relieving double-J stent-related discomfort: a randomized controlled clinical trial.

IntroductionThe aim of this study was to investigate the effect of 50 mg mirabegron once daily in relieving ureteral double-J (DJ) stent-related discomfort after ureteroscopy (URS) or retrograde intrarenal surgery (RIRS).Material and methodsA total of 210 patients who underwent DJ ureteral stent insertion after URS or RIRS were randomized 1:1 to receive either no treatment (Group B) or mirabegron 50 mg once daily (Group A) during the stenting period. At time of stent removal, all patients were evaluated for stent-related symptoms using the Arabic translated and validated ureteral stent symptom questionnaire (USSQ). The severity of stent-related symptoms (SRS) was compared between the two groups.ResultsThe mean age was 46.6 ±8.2 years in Group A and 44.7 ±9.4 (26–64) years in the control group (p = 0.13). The stone characteristics, stent size, and position were similar in both groups. Compared to the control group, the mirabegron group had significantly lower daytime frequency, nocturia and urgency (p = 0.028, p = 0.008 and p = 0.012, respectively). As for stent-related pain, Group A had significantly less flank and abdominal pain (p = 0.007 and p = 0.001, respectively). The mirabegron versus control group showed significant difference in mean analgesics use and quality of life (QoL) scores during the stenting period (p = 0.005 and p = 0.003, respectively). Three patients (2.9%) in Group A encountered minor adverse effects (two experienced dry mouth and one presented with constipation).ConclusionsFor patients with indwelling DJ stent, postoperative mirabegron 50 mg use was effective and well-tolerated for the treatment of lower urinary tract symptoms and stent-related pain.

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.

Évaluation de la tolérance de la sonde JJ par l’utilisation de l’auto-questionnaire USSQ

Evaluation of the quality of life patients with a ureteral catheter JJ (US). This study was conducted from 01/2016 to 15/02/2017, including all patients operated on a rise of US. The USSQ questionnaire (Ureteral Stent Symptom Questionnaire) validated in French in 2010 was filled during the perioperative period with SU in place (S1), 4 weeks after putting the US (S2) and 4 weeks after removal of the US (S3), it is grouped into 6sections: urinary symptoms, body pain, general condition, professional impact, sexuality, other problems. The Wilcoxon test was used to compare the statistical averages. We identified 150patients including 89women (59.3%) and 61 men (40.7%). The average age of our patients is 49.5years. The quality of life appeared to be significantly altered in all areas explored by the questionnaire: urinary symptoms had a mean score one week after the US rise (S1) was 29.5 versus 25.3 at four weeks after ablation (S3) of US at P<0.0001), pain persisted at four weeks after US ablation at an average S3 score of 10.6 versus 14.5 at S1 at P=0.003. The patients' EG was also altered after the placement of the SU: S1 of 16.6 versus S2 18.5 (P<0.0001), the presence of a US did not have a great impact on the activity professional active patients: active (S1 of 14.9 versus S3 of 13.3 P=0.6). But it was a sexual disability of the sexuality carrier: average score of 5.3 in S1 vs. 5.2 in S3 for a value=0.122. There is no significant difference if the US is raised urgently or in a scheduled manner. US appears to have a significant impact on the quality of life of patients. 3.

Comparison of a magnetic retrieval device vs. flexible cystoscopy for removal of ureteral stents in renal transplant patients: A randomized controlled trial.

Placement of a ureteral stent at the time of renal transplantation can reduce complications when compared to non-stented anastomoses. Removal by flexible cystoscopy can be associated with discomfort, risk for infection, and high costs. New magnetic stents offer a means of bypassing cystoscopy by use of a magnetic retrieval device. Our objective was to compare clinical and cost-related outcomes of conventional and magnetic stents in patients undergoing deceased donor renal transplantation. Patients were randomized to receive either a conventional or a Black-Star® magnetic stent. Clinical, procedural, and cost outcomes were assessed, and the Ureteral Stent Symptom Questionnaire (USSQ) was administered with the stent in situ and after stent removal. All variables were compared between groups. Forty-one patients were randomized to conventional (n=19) or Black-Star (n=22) stent. The total time for stent removal under cystoscopy was significantly longer compared to Black-Star removal (6.67±2.47 and 4.80±2.21 minutes, respectively, p=0.019). No differences were found in the USSQ domains between groups. Rates of urinary tract infections and surgical complications between groups were similar. Stent removal was well-tolerated in both groups. Black-Star stent use resulted in a cost savings of $304.02 Canadian dollars (CAD) per case. USSQ scores suggest that stent removal with the Black-Star magnetic stent is as equally well-tolerated as flexible cystoscopy by renal transplant patients. Black-Star stent removal was significantly faster than conventional stents. No differences in discomfort, infection rate, or complication rate were found. Use of the Black-Star stent resulted in an estimated annual savings of $27 360 CAD at our centre.

Transient stent placement versus tubeless procedure after ureteroscopy retrograde surgery stone extraction (Fast Track Stent study2): A randomized prospective evaluation.

To determine whether in pre-stented patients undergoing ureteroscopic stone removal (ureteroscopy retrograde surgery) a tubeless procedure provides a better outcome compared with short-term (6h) ureteral stenting using an external ureteral catheter. In this single academic center study (Fast Track Stent study2), carried out between May 2016 and April 2018, 121 patients with renal or ureteral calculi were initially treated with double-J insertion. Before secondary ureteroscopy retrograde surgery, patients were prospectively randomized into two groups: tubeless versus ureteral catheter insertion for 6h after ureteroscopy retrograde surgery. Exclusion criteria were acute urinary tract infection, solitary kidney or stone diameter >25mm. Study end-points were stent-related symptoms assessed by a validated questionnaire (ureteral stent symptom questionnaire), administered both before and 4weeks after surgery. Numerical ureteral stent symptom questionnaire scores were compared using the Mann-Whitney-U-test. The level of significance was defined as P<0.05. Ureteroscopy retrograde surgery procedures carried out by 13 surgeons resulted in >90% stone removal in all patients (n=121), with a mean operation time of 19.9 versus 18.0min for ureteral catheter versus tubeless, respectively (P=0.37). Patient groups did not differ significantly in their ureteral stent symptom questionnaire scores (urinary index P=0.24; pain index P=0.35). Patients showed a significant preference for tubeless procedure over ureteral catheter reinsertion (Question GQ P<0.0001). The reintervention rate was 13.3% for the tubeless procedure (n=8) and 1.6% for the ureteral catheter group (n=1), respectively (P=0.034). Short-term ureteral catheter and no stent insertion after ureteroscopy retrograde surgery stone extraction in pre-stented patients result in comparable quality of life. However, the reintervention rate is higher for tubeless procedures.

Effects of Silicone Hydrocoated Double Loop Ureteral Stent on Symptoms and Quality of Life in Patients Undergoing Flexible Ureteroscopy for Kidney Stone: A Randomized Multicenter Clinical Study.

We compared the hydrocoated silicone stent (Coloplast Imajin® hydro) to Percuflex™ Plus stent (Boston Scientific) in terms of patient comfort and quality of life after flexible ureteroscopy for stone disease over a 5-week prospective followup. This is a multicenter, single-blind, prospective, randomized trial of 141 patients treated with flexible ureteroscopy for renal stones. Primary outcome was Ureteral Stent Symptom Questionnaire (USSQ) Body Pain Index recorded before Double-J® stent removal at day (D) 20. Secondary endpoints were USSQ scores at intermediate dates (D2, D7, D20) and 2 weeks after stent withdrawal (D35), occurrence of adverse events and stent encrustation. The trial was completed by 113 (80.1%) patients. Mean (SD) USSQ body pain scores were 25% lower at D20 for the silicone stent at 18.7 (11.4) vs 25.1 (14.2) (p=0.015). No difference in terms of adverse events and safety profile was observed. USSQ urinary symptoms scores at D2, D7 and D20 were lower in the silicone stent group at 26.4 (7.7) vs 31.8 (8.1) at D20 (p <0.001). The use of USSQ self-questionnaires was associated with a limited number of missing or incomplete answers. The primary results of this large sample prospective randomized controlled study comparing the silicone Imajin hydro stents to the Percuflex Plus stent show that silicone stents are associated with significantly less patient discomfort. We would recommend their use in patients who require stenting for stone disease.

Валидация русскоязычной версии опросника для оценки качества жизни и симптомов, связанных с мочеточниковым стентом Ureteric Stent Symptoms Questionnaire (USSQ)

Ureteral stents are frequently used in urology practice and have a significant impact on health-related quality of life (QoL). In 2003 . Joshi et al. developed the specific questionnaire for evaluation of QoL and stent-related symptoms, namely Ureteral Stent Symptoms Questionnaire (USSQ). USSQ consists of 40 questions and 2 visual analog scales (VAS), divided into 6 domains. Over the past decade, this questionnaire has been translated into 9 languages. A Russian version of the questionnaire has not been developed yet. To perform linguistic validation of the Russian version of the USSQ. Linguistic validation of the original USSQ was performed through a standard process including translation, back translation and pilot study. A total of 103 patients undergone ureteral stent placement and successfully filled in the Russian USSQ at weeks 1 and 4 after stenting, and at week 4 after stent removal. In addition, 30 healthy people filled in the same questionnaires twice at 3-week intervals, as a control group. To evaluate reliability, validity and sensitivity to change of the Russian USSQ, statistical analysis was performed. External criteria included validated questionnaires (EQ-5D, IPSS and pain VAS). Content validity was approved by experts and proved during patients interviewing. Reliability test-retest was satisfactory for urinary symptoms, body pain, general health, and work performance domains (p<0,001 between test and retest evaluation). USSQ domains showed good correlations between each other (correlation coefficient was 0,80-0,94). Cronbach's alpha coefficient of internal reliability was 0.73-0.95. Correlation between other instruments and corresponding USSQ domains was good (p<0,001), proving criterial validity. Sensitivity to changes after stenting and stent removal was also good for most domains (p less or equal 0,001). Russian version of USSQ is a valid, reliable and sensitive instrument for the assessment of QoL and stent-related symptoms and is ready for application in the routine clinical practice.

LBA01-03 COMPARISON OF MIRABEGRON, SOLIFENACIN AND TAMSULOSIN FOR STENT RELATED SYMPTOMS: A DOUBLE BLINDED RANDOMIZED CONTROL TRIAL

You have accessJournal of UrologyLate-Breaking Abstracts (LBA1)1 Apr 2020LBA01-03 COMPARISON OF MIRABEGRON, SOLIFENACIN AND TAMSULOSIN FOR STENT RELATED SYMPTOMS: A DOUBLE BLINDED RANDOMIZED CONTROL TRIAL Abhishek Chandna*, Santosh Kumar, Uttam Kumar Mete, Sudheer Kumar Devana, Aditya Prakash Sharma, and Samir Malhotra Abhishek Chandna*Abhishek Chandna* More articles by this author , Santosh KumarSantosh Kumar More articles by this author , Uttam Kumar MeteUttam Kumar Mete More articles by this author , Sudheer Kumar DevanaSudheer Kumar Devana More articles by this author , Aditya Prakash SharmaAditya Prakash Sharma More articles by this author , and Samir MalhotraSamir Malhotra More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000946.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Introduction: Ureteral double J (DJ) stents are associated with stent related symptoms (SRSs) in up to 80% patients. Alpha blockers and anti-cholinergics have demonstrated efficacy in ameliorating SRSs. Mirabegron, a novel beta-3 receptor antagonist, demonstrated benefit in overactive bladder, with beta-3 receptors found in the ureter as well. We conducted a double blinded randomized control trial (MIRASOTA; CTRI/2019/02/017808) to evaluate the efficacy of mirabegron in ameliorating SRSs as compared to solifenacin or tamsulosin. Methods: Between October 2018 and December 2019, 150 patients undergoing DJ stent placement following ureteroscopic stone removal (URS), percutaneous nephrolithotomy (PCNL) or lap/robotic pyeloplasty were randomized in a 1:1:1 fashion into 3 groups. Patients in groups A, B and C received mirabegron 50 mg, solifenacin 5mg and tamsulosin 0.4mg once a day respectively. Stent was removed 4 weeks after surgery. Patients were followed at POD10 (I visit), 4 weeks (II visit) post surgery and 2 weeks post-stent removal. Validated vernacular version of ureteral stent symptoms questionnaire (USSQ) was evaluated at each visit. Results: Out of the 150 patients randomized, 124 patients (A; n = 42, B; n = 40 and C; n = 42) completed the study. Two patients in group C withdrew from the study due to side effects. Protocol violation was the most common reason for exclusion. Baseline demographic variables were comparable across groups. The groups were comparable in terms of urinary index score of USSQ at I and II visits (p = 0.111 and 0.084, respectively). No significant difference was observed between the groups in terms of pain index (p = 0.054 and 0.409, respectively). However, a significantly lower proportion of patients in group B persisted to have bodily pain at II visit (p = 0.035). Patients in group A demonstrated significantly better general health index scores at I visit (p = 0.021), which were not replicated at II visit (p = 0.684). No significant differences were observed in terms of sexual score or work performance. Constipation and dry mouth were noted in 14.7% patients in group B whereas headache (7.1%) was the most common side effect in group A. There was no significant association between drug group and type of surgery. Conclusions: Mirabegron has shown comparable benefit in alleviating SRSs and may be beneficial in cases where tamsulosin or solifenacin are contra-indicated or poorly tolerated. The MIRASOTA trial is first and only double blinded RCT comparing mirabegron with tamsulosin or solifenacin for SRSs. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1020-e1020 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Abhishek Chandna* More articles by this author Santosh Kumar More articles by this author Uttam Kumar Mete More articles by this author Sudheer Kumar Devana More articles by this author Aditya Prakash Sharma More articles by this author Samir Malhotra More articles by this author Expand All Advertisement PDF downloadLoading ...

A Study to Compare the Safety and Efficacy of Solifenacin, Tamsulosin and Tadalafil in Relieving Double-J Stent Related Symptoms

Objective: To evaluate and compare the safety and efficacy of Solifenacin, Tamsulosin, and Tadalafil in treating ureteral stent related symptoms (SRS) in patients with indwelling Double-J ureteral stents. Materials and Methods: A prospective randomized controlled study was conducted on 146 consecutive patients in the department of urology, Government Stanley Medical College & Hospital, Chennai, Tamilnadu, India between Sept 2017-March 2019, with SRS after taking informed consent and confirming DJ Stent position by X-ray KUB post-operatively. Patients were randomized into 4 groups: Group A (Placebo), Group B (Solifenacin 5 mg), and Group B (Tamsulosin 0.4 mg) and group D (Tadalafil 5 mg) at end of 1st week till the removal of DJ stent at end of 3 weeks. All patients were assessed for bothersome lower urinary tract symptoms (LUTS) using the validated Ureteral Stent Symptom Questionnaire (USSQ) at 1st week and 3 weeks after the starting of medications. Appropriate statistical analysis as carried out and the level of significance was set at P α-blockers in relieving urinary symptoms and is more efficacious in relieving sexual symptoms and body pain.

Effectiveness of Tamsulosin compared with Mirabegron in treatment of Double-J Stent-Related Lower Urinary Tract Symptoms

Introduction: The ureters stent has side effects that the complaint is called stent-related syndrome (SRS). The complaint is equal to Lower Urinary Tract Symptoms (LUTS) and overactive bladder (OAB). Alpha-blocker and antimuscarinic therapy used for benign prostatic hyperplasia (BPH) and OAB therapy can also be used to reduce complaints of SRS. The purpose of this research is to determine the effectiveness of Tamsulosin 0.4 mg/day compared with Mirabegron 50 mg/day against changes in LUTS complaints in patients after the installation of the Ureteric Stent. Methods: The design of this research uses a double-blinded experimental method. Samples taken randomly were 50 patients with Double-J (DJ) Stent post-installation LUTS complaints. Data collection is taking place from July to November 2019, using a tool measuring instrument ureteral stent symptom questionnaire (USSQ). Data were analyzed using SPSS 24.0. a P-value < 0.05 was considered to be statistically significant. Results: In the entire patient group, the average age of respondents is 44.86 ± 11.85 year, in groups with Tamsulosin 5 mg/day treatment compared with Mirabegron 50 mg/day gives a good effect in lowering the complaint score LUTS during 4 weeks post-installation of Double-J (DJ) Stent, in this case, Urinary Symptoms, pain, general circumstances, work activity, and other complaints (P < 0.05). The average rate reduction of USSQ Urinary Symptoms, pain, general circumstances, greater work activity in the Tamsulosin group. Conclusion: Tamsulosin Therapy 5 mg/day compared with Mirabegron 50 mg/day can effectively cure complaints of post-installation LUTS DJ Stent.

A New Customized Ureteral Stent with Nonrefluxing Silicone End-piece to Alleviate Stent-related Symptoms in Malignant Diseases

To evaluate the stent-related symptoms using a new customized ureteral stent with a nonrefluxing silicone end-piece. By decreasing the amount of material within the bladder, it should be possible to attenuate the stent-related symptoms. To minimize the amount of material, 17 consecutive patients already fitted with a double-pigtail stent for malignant ureteral obstruction agreed to be fitted with a customized stent where the bladder loop was replaced by a nonrefluxing silicone end-piece. The ureteral stent symptom questionnaire was prospectively administered to patients at baseline with double-pigtail stent and Day 15 after customized stent placement. No difficulty in the placement of the customized stent was encountered. No stent failure, no dislodgment and no calcification were observed 6 months after stenting. The scores for the main domain "Urinary symptoms" (34.4 ± 3.6 vs 23.0 ± 7.0; P=.0004) and the question "Global quality of life" (4.4 ± 2.0 vs 2.4 ± 2.1; P=.01) were significantly decreased by the replacement of the double-pigtail stent by the customized stent. The customized ureteral stent may constitute an improvement in the field of stent-related symptoms and seems fit for use in its current shape. Studies exploring and exploiting new concepts are greatly required to reduce stent-related symptoms in all patients including those with cancer.

Effects of tamsulosin hydrochloride sustained release capsule in improving symptoms and quality of life of patients with indwelling double-J ureteral stents

Objective To investigate the influence of tamsulosin hydrochloride sustained release capsule in improving symptoms and quality of life of patients with indwelling double-J ureteral stents. Methods From March 2016 to June 2017, 96 patients with indwelling double-J ureteral catheter were randomly divided into control group and observation group, with 48 patients in each group. The control group did not take drugs after operation, and the patients in the observation group were treated with tamsulosin hydrochloride sustained release capsule once a day, totally for 1 month. All the enrolled patients completed the Ureteral Stent Symptom Questionnaire (USSQ), the International Prostate Symptom Score (IPSS) , quality of life (QOL), visual analogue scale (VAS) as well as the Overactive Bladder Symptom Score (OABSS) on the day after the removal of the stent 4 weeks after treatment. Results The mean urinary symptom index score, the pain index score, the sex index score and the ability index of work score of the observation group were (25.23±4.35), (14.58±2.84), (3.82±1.03) and (12.83±3.85) , lower than the score (31.29±4.48), (30.39±3.91), (5.83±1.94) and (18.81±5.03) of the control group. The storage stage score and IPSS total score were respectively (3.31±1.38) and (6.87±2.94), lower than the score (6.14±2.03) and (10.31±2.26) of the control group. The QOL, VAS, OABSS score were (1.54±0.93 ), (1.95±1.07) and (4.31±1.28), lower than the score(3.24±0.93), (4.04±1.23) and (9.29±2.87) of the control group. As opposed to the control group, it was observed that observation group prominently improved and the scores were statistically significant(P<0.05). Conclusions Tamsulosin hydrochloride sustained release capsule can significantly improve the related symptoms of indwelling double-J ureteral stents and prostatic symptoms, reduce pain, improve patient's quality of life. Key words: Urinary Catheterization; Adrenergic alpha-Antagonists; Signs and Symptoms; Quality of Life