Does mirabegron relieve ureteric stent‐related discomfort? A prospective, randomized, multicentre study

Tae, Bum Sik; Cho, Seok; Jeon, Byeong Jun; Choi, Hoon; Park, Jae Young; Cho, Sung Yong; Lee, Keon-Cheol; Bae, Jae Hyun

doi:10.1111/bju.14416

Cited by 30 publications

(47 citation statements)

References 29 publications

(44 reference statements)

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“…In addition, it has been reported to be an effective and safe medical expulsive treatment agent for the reduction of distal ureteral stones with a low rate of side effects [4,14]. Mirabegron reduces the disturbing symptoms related to stents by dilatation of the ureter and decreasing intraluminal pressure [15]. These effects led to the idea that the use of mirabegron during UAS placement might provide convenience to the surgeon.…”

Section: Discussionmentioning

confidence: 99%

Can mirabegron facilitate ureteral access sheath placement during flexible ureterorenoscopy?

2020

Ann Clin Anal Med

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Aim: In this study, we aimed to demonstrate the effect of mirabegron on ureteral access sheath (UAS) placement during flexible ureterorenoscopy (f-URS). Material and Methods: The study enrolled 96 patients with renal stones who underwent fURS between October 2019 and March 2020. The patients were divided into 2 groups. Mirabegron treatment was administered 2 weeks before fURS in Group 1 (n = 41), and no mirabegron treatment was given in Group 2 (n = 55). All operations were performed by a single surgeon (MK). Demographic characteristics were recorded for each patient, including age, body weight, height, body mass index (BMI), stone characteristics, and perioperative data, including operation-fluoroscopy durations, stone-free rates, complications, and surgery success rates. Group data were compared, and p-values less than 0.05 were considered statistically significant. Results: No significant difference was detected between the groups in terms of age, sex, body mass index, number and size of stones, side of stones, density of stones, and renal hydronephrosis level. UAS placement in Group 1 was found to be statistically significant at the first attempt (without using a semi-rigid ureteroscope or balloon dilatation) compared with Group 2 (p=0.001) Discussion: The use of mirabegron may facilitate UAS placement during fURS with less operation time and fewer complications.

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Section: Discussionmentioning

confidence: 99%

Can mirabegron facilitate ureteral access sheath placement during flexible ureterorenoscopy?

2020

Ann Clin Anal Med

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“…The authors concluded that 50 mg Mirabegron had the potential to reduce ureteric stent-related discomfort. 85 A large RCT by Ragab et al highlighted that patients with both pregabalin and solifenacin had better USSQ scores and pregabalin alone was well tolerated and safe in patients with stent-related symptoms. 86,87 A small study by Tharwat et al showed that sildenafil was tolerated in men with ureteral-related symptoms.…”

Section: Beta-3 Adrenergic Agonistsmentioning

confidence: 99%

“…The authors concluded that 50 mg Mirabegron had the potential to reduce ureteric stent-related discomfort. 85 …”

Section: Pharmacological Strategies To Improve Stent-related Symptomsmentioning

confidence: 99%

<p>Strategies to Improve Patient Outcomes and QOL: Current Complications of the Design and Placements of Ureteric Stents</p>

Ramachandra

Mosayyebi²,

Carugo³

et al. 2020

RRU

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Ureteric stents have played a vital role in relieving urinary obstruction in many urological conditions. Although they are extremely successful, stents have been associated with complications and reduced patients' health-related quality of life (HRQoL). There are many factors that may affect the quality and longevity of stents. In this review, we have highlighted the journey and innovation of ureteric stents through the modern day. A literature review was conducted to identify relevant articles over the last 20 years. There is a plethora of evidence with various indications for the use of ureteral stents and how they affect QoL. There is still ongoing research to develop the ideal stent with reduced encrustation, one that resists infection and is also comfortable for the patients. Stents made from metal alloys, polymers and biodegradable materials have unique properties in their own right but also have certain deficiencies. These have been discussed along with an overview of newly developed stents. Certain pharmacological adjuncts have also been highlighted that may be useful to improve patient's tolerance to stents. In summary, this paper describes the features of the different types of stents and the problems that are frequently encountered, including effect on patients' HRQoL and financial burden to healthcare providers.

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“…In a study by Lennon et al, a significant increase in SRS was attributed to ureteral stent firmness [12]. The magnitude of stent firmness is reliant on the material ureteral stents are composed of.…”

Section: Introductionmentioning

confidence: 99%

“…These characteristics include the length of the stent [5], stent positioning [6], changing bladder pig tail to loop type [7], use of stents with special coatings [8], and composition of biomaterials of different firmness [9]. Additionally, the use of alpha1-and choline blockers, with their combinations [10], nonsteroidal antiinflammatory drugs [11] and mirabegron [12] have also been studied in order to reduce intensity of SRS experienced by patients. Despite this, patients with indwelling stents continue to experience SRS [13].…”

Section: Introductionmentioning

confidence: 99%

Comparison of silicone versus polyurethane ureteral stents: a prospective controlled study

et al. 2020

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Background: Approximately 80% of patients with indwelling ureteral stents experience stent related symptoms (SRS). We believe SRS can be reduced through altering the composition of ureteral stents to a less firm material. Therefore, we aim to compare modern silicone and polyurethane ureteral stents in terms of SRS intensity and safety. Methods: From June 2018 to October 2018, patients from two distinct clinical centers were prospectively enrolled in the study and stratified (non-randomly) into either control group A, patients who received polyurethane stents (Rüsch, Teleflex), or experimental group B, patients who received silicone stents (Cook Medical). Each participant completed a survey 1 h after stent insertion, in the middle of the stent dwelling period, and before stent removal or ureteroscopy noting body pain and overactive bladder via the visual analog scale pain (VASP) and overactive bladder (OAB) awareness tool, respectively. Additionally, successfulness of stent placement, hematuria, number of unplanned visits, and stent encrustation rates were assessed within each group. Results: A total of 50 patients participated in the study, control group A consisted of 20 patients and experimental group B consisted of 30 patients. Participants in group B, silicone ureteral stents, demonstrated significantly lower mean values of VASP 2 weeks prior to stent removal and promptly before stent removal (p = 0.023 and p = 0.014, respectively). No other comparisons between the two groups were statistically significant. Conclusions: Compared to polyurethane ureteral stents, silicone ureteral stents are associated with lower body pain intensity assessed by VASP 2 weeks before stent removal and at the time of stent removal. Trial registration: Current Controlled Trials NCT04000178. Retrospectively registered on June 26, 2019.

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Does mirabegron relieve ureteric stent‐related discomfort? A prospective, randomized, multicentre study

Abstract: The use of 50 mg mirabegron once daily has the potential to reduce ureteric stent-related discomfort. Prospective larger-scale, placebo-controlled studies are warranted to further evaluate the beneficial effects of mirabegron on stent-related symptoms.

Cited by 30 publications

References 29 publications

Can mirabegron facilitate ureteral access sheath placement during flexible ureterorenoscopy?

Can mirabegron facilitate ureteral access sheath placement during flexible ureterorenoscopy?

<p>Strategies to Improve Patient Outcomes and QOL: Current Complications of the Design and Placements of Ureteric Stents</p>

Comparison of silicone versus polyurethane ureteral stents: a prospective controlled study

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