Effects of naftopidil on double-J stent-related discomfort: a multicenter, randomized, double-blinded, placebo-controlled study

Abstract

To evaluate the effect of naftopidil 75 mg once daily for ureteral double-J (DJ) stent-related discomfort after a ureteroscopic procedure using a multicenter, randomized, double-blinded, placebo-controlled study. 100 patients with indwelled retrograde DJ ureteral stents after ureteroscopic stone removal or retrograde intrarenal surgery (RIRS) were randomized 1:1 to receive either placebo or naftopidil during the stenting period. At the time of stent removal, the Ureteral Stent Symptom Questionnaire (USSQ), the International Prostate Symptom Score and the total amount of used analgesics were reported. Of the 92 patients who completed the study, 49 patients were enrolled in the placebo group, and 43 patients in the naftopidil group. USSQ urinary symptom scores (30.90 vs. 29.23, p = 0.299) and USSQ body pain scores (22.28 vs. 19.58, respectively, p = 0.286) were lower in the naftopidil group than in the placebo group, but the difference was not significant. Multivariate analysis showed that the use of a ureteral access sheath during RIRS was the only significant predictor of postoperative DJ-related pain (OR = 2.736, p = 0.031). The use of naftopidil once daily did not significantly reduce DJ ureteral stent-related discomfort. Larger-scaled prospective studies should be conducted to evaluate the effects of naftopidil on DJ stent-related symptoms and surgeries.

Comparison of 4.8 Fr and 6 Fr ureteral stents on stent related symptoms following ureterorenoscopy: A prospective randomized controlled trial

“…The previous reports have demonstrated that ureteral stenting was clearly associated with worsening life quality and general health. Joshi et al have stated that 72% of patients were very dissatisfied and desperate after stent insertion but that rate decreases to 4% after stent removal (p Z 0.0001) [13]. In our study, the total USSQ score decreased after stent removal in groups 1 and 2.…”

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

“…The USSQ was developed to evaluate the discomfort associated with ureteric stents and it is currently widely used . The exact mechanism involved in ureteric stent‐associated discomfort is not yet known; however, many authors report that such discomfort is associated with ureteric spasms, urinary reflux attributable to ureteric stent, or trigonal irritation .…”

“…The USSQ was developed to evaluate the discomfort associated with ureteric stents and it is currently widely used [11]. The exact mechanism involved in ureteric stent-associated discomfort is not yet known; however, many authors report that such discomfort is associated with ureteric spasms, urinary reflux attributable to ureteric stent, or trigonal irritation [12]. Different novel types of stents have been developed and evaluated to reduce stent-related discomfort; however, there is still controversy regarding their clinical application [13].…”

Complete intraureteral stent placement relieves daytime urinary frequency compared with conventional placement in patients with an indwelling ureteral stent: post-hoc analysis of a randomized, controlled trial

“…To date, many studies have attempted to alleviate stent-related discomfort by agents, such as alpha-1 blockers, anticholinergics, and beta-3 adrenergic receptor agonists 13,[19][20][21][22] . These results regarding improvement of urinary symptoms are conflicting, and negative results have been found in several randomized, controlled trials 13,[20][21][22] . We believe that trials using medication should consider not only improvement of stent-related irritation, but also urinary symptoms that the patient has 23 .…”