Efficacy of Tamsulosin in relieving double-J stent-related symptoms: a randomized controlled study

Abstract

Introduction: Ureteral stent placement is an increasingly common procedure in urological practice.They are used for both prevention and treatment of ureteral obstruction. Despite improved design and materials, many patients still develop stent-related symptoms which commonly affect quality of life and sometimes necessitate early removal. Tamsulosin improves stent-related symptoms and quality of life, and can be applied in routine clinical practice. In the present study, the effect of Tamsulosin in improving double-J stent-related symptoms and quality of life following ureteral stent placement was studied.Methods: This RCT was carried out in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from February 2015 to January 2016. Forty six patients were included in the study and randomized into Tamsulosin(T) group and Control(C) group each having 23 patients. In addition to standard postoperative care, Tamsulosin group received 0.4mg Tamsulosin daily and Paraceramol on demand and control group received only Paracetamol. Stent related symptoms and quality of life was assessed by IPSS at discharge (day2) and at the time of DJ stent removal (2 weeks). Pain was evaluated by VAS and analgesic requirement was documented. Data were analysed using SPSS 20, chi-square test and Student’s t- test was used. A p-value of <0.05 was considered significant.Results: Mean age in Tamsulosin group was 37.96±12.98 and Control group 36.43± 10.99(p=0.67).There was no significant difference in IPSS(p=0.141), QoL index (p=0.089) and VAS (p=0.59) in the two groups at the time of discharge.At the time of DJ stent removal, IPSS (p<0.001), QoL index (p<0.001), VAS (p=0.004) and analgesic needed (p<0.001) was significantly lower in T group than in C group.Conclusion: Tamsulosin lowers stent related symptoms, pain and improves quality of life in patients with indwelling DJ stent though the effect is not immediate.

Tamsulosin in Lowering Double J Related Symptoms

“…At the time of DJ removal there was significant difference noted in all the parameters. 18 This study also showed similar results at the time of DJ removal. At the time of discharge, Thakur et al didn't show any difference between the two groups but in this study there was significant difference noted.…”

“…Each patient filled a written form on IPSS, at the time of discharge and on the day of stent removal; with zero being least and 35 being the maximum out of 35 score. With the help of IPSS individuals are further divided into mild (1-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and severe symptoms (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).QoL is scored from 0-6, in which zero being best goal and 6 states that patient is in the terrible condition. Visual analogue scale (VAS) ranges from one to 10, one being the least and 10 being the maximum pain which he/she has never experienced.…”

Simulation, Fabrication and Analysis of Silver Based Ascending Sinusoidal Microchannel (ASMC) for Implant of Varicose Veins

“…The proposed option for the cure of this disease and to make blood flow better is to use a bioengineered vein (silver microchannel) in the varicose vein. There are similar examples of stent implantation [ 82 , 83 , 84 , 85 ]. The bioengineered blood vessel also appears to be safe for dialysis process.…”

The efficacy of tamsulosin and solifenacin versus tamsulosin alone in double-J stent associated with lower urinary tract symptoms.

“…The studies have shown that antimuscarinics and alpha-blockers can help to improve lower urinary tract symptoms due to DJStent 1,7 . Compared to the placebo, Tamsulosin helps individuals with DJ stents reduce stentrelated symptoms and improve quality of life 8,9 . In a clinical trial, Tamsulosin and Solifenacin were compared with placebo; Tamsulosin increased DJSrelated irritative symptoms by 7.68 ± 3.66 and Solifenacin by 6.62 ± 3.92, which indicates that IPS irritative scores were higher than placebo 6 .…”