Management of JJ stent-related symptoms

Papatsoris, Athanasios; Dellis, Athanasios; Daglas, George; Sanguedolce, Francesco

doi:10.2298/aci1401073p

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…This method provides adequate urinary drainage, facilitating rapid closure of the urine leak site and is well tolerated with only mild discomfort reported by the patient. 3 …”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Massive Dilation of the Ureter: An Endoscopic Management of Persistent Urinary Leak After Partial Nephrectomy

PardalidisPanagiotis

AndriopoulosNick

KosmaoglouEleni

et al. 2017

Journal of Endourology Case Reports

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Introduction: The incidence of urinary leakage is increased as nephron sparing surgery becomes more used for the management of small renal masses. We present an endourologic approach in a patient with a persistent urinary leak after partial nephrectomy by placing two synchronous ureteral stents to improve drainage and avoid further potential surgery.Patients and Method: A 39-year-old patient presented with a urine leak on the fifth postoperative day after an open partial nephrectomy. Initially, the leakage was managed with a placement of a 6F Double-J stent. However, due to persistence of leakage after a month, two ureteral stents (a 6F Double-J stent and a 14F endopyelotomy stent) were placed. With this maneuver, the ureter was dilated to 20F and a bladder catheter was placed to complete the drainage.Results: At 3 weeks, a CT urography was performed, which showed complete resolution of the urinary leakage compared with previous examination. The stents were removed the following day and the patient required no further intervention. The follow-up examination was continued for 24 months without any symptom of the patient and any sign of leak recurrence.Conclusion: Endoscopic approach to urinary leak after partial nephrectomy obtaining high ureteral gauge can be a good alternative, avoiding more aggressive surgical approaches.

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“…This method provides adequate urinary drainage, facilitating rapid closure of the urine leak site and is well tolerated with only mild discomfort reported by the patient. 3 …”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Massive Dilation of the Ureter: An Endoscopic Management of Persistent Urinary Leak After Partial Nephrectomy

PardalidisPanagiotis

AndriopoulosNick

KosmaoglouEleni

et al. 2017

Journal of Endourology Case Reports

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“…anti-cholinergics, α-blockers or combinations, with varying results [7], [8], [9], [10]. However, a placebo-controlled study with a multi-drugs comparative protocol is deficient.…”

Section: Discussionmentioning

confidence: 99%

Drug treatment of bothersome lower urinary tract symptoms after ureteric JJ-stent insertion: A contemporary, comparative, prospective, randomised placebo-controlled study, single-centre experience

Hekal

2016

Arab Journal of Urology

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ObjectiveTo provide a guide for medication to alleviate bothersome lower urinary tract symptoms (LUTS) in patients after JJ ureteric stenting.Patients and methodsBetween June 2011 and June 2015, a prospective randomised placebo-controlled study was conducted on 200 consecutive cases of ureteric stones that required JJ stents. All patients had signed informed consent and JJ-stent placement confirmed by X-ray. The patients were randomised into five groups: A, solifenacin 5 mg; B, trospium chloride 20 mg; C, antispasmodic; and E, α-blocker; and a placebo group (D). A standard model was created to lessen patient selection bias. Eligible patients were enrolled and assessed for side-effects and bothersome LUTS using the validated Ureteric Stent Symptoms Questionnaire. Appropriate statistical analysis was carried out.ResultsIn all, 150 male patients in the five groups were compared. LUTS were less in groups A and B (P < 0.05), while dry mouth was significantly reported in Group A. Individual comparisons with the placebo group showed a non-significant difference with Group C, while Group E had significant nocturia improvement. Selective comparison of two best groups (A and B) showed less frequency in Group B, while the other LUTS were less in Group A with comparable side-effects.ConclusionsIn symptomatic patients following JJ-stent insertion, anti-muscarinic medication, namely solifenacin 5 mg or trospium chloride 20 mg, was the best. The advantage of trospium over solifenacin is in the control of frequency rather than the other symptoms. Addition of an α-blocker (alfuzosin 10 mg) is valuable when nocturia is the predominant symptom.

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“…Ureteric stents are routinely used in urology, suggesting a relatively simple, useful, and indispensable tool in everyday practice for more than five decades [1]. However, there is considerable controversy over whether a stent is needed, especially in uncomplicated ureteroscopy cases or even before extracorporeal shockwave lithotripsy [2,3]. As there have been significant improvements in stone management during the last decade, the indications for and complexity of ureteroscopy have increased and consequently the use of indwelling stents [4].…”

Section: Introductionmentioning

confidence: 99%

Management of stent-related symptoms with the use of α-blockers: A meta-analysis

Deliveliotis

Papatsoris

Skolarikos

et al. 2019

Arab Journal of Urology

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Objectives: To assess the effectiveness of α-blockers at reducing stent-related morbidity compared to placebo using the Ureteric Symptom Score questionnaire (USSQ) at particular time points as originally set by the developers of the USSQ. Materials and methods: We conducted the study following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Eligible articles were identified by a search of the Medical Literature Analysis and Retrieval System Online (MEDLINE) database for the period from 1 January 2006 to 30 November 2018. The search strategy included specific keywords and only articles in English were considered eligible. A meta-analysis of randomised controlled trials was done according to methodological quality, placebo-control use, and USSQ completion at the time points of 1 and 4 weeks after insertion, and 4 weeks after stent removal. The mean differences with 95% confidence intervals were calculated for outcomes, with a P < 0.05 considered statistically significant. Results: In all, eight papers were included for analysis. At 1 week after stent insertion, α-blockers were associated with a significant decrease in the USSQ Urinary Index score (UIS), Pain Index score, General Health Index score (GHIS), Sex Index score, and Work Index score (WIS). At 4 weeks after stent insertion, α-blockers were associated with a significant decrease in the UIS, GHIS and WIS only, whilst at 4 weeks after stent removal, α-blockers were associated with a significant decrease in the UIS and GHIS. Conclusions: The oral administration of α-blockers or their combinations have been shown to relieve stent morbidity, especially during the early period of stenting. The use of selective agents can therefore be considered; however, there is still the need for uniformly designed multi-centre randomised studies.

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Management of JJ stent-related symptoms

Cited by 6 publications

References 7 publications

Massive Dilation of the Ureter: An Endoscopic Management of Persistent Urinary Leak After Partial Nephrectomy

Massive Dilation of the Ureter: An Endoscopic Management of Persistent Urinary Leak After Partial Nephrectomy

Drug treatment of bothersome lower urinary tract symptoms after ureteric JJ-stent insertion: A contemporary, comparative, prospective, randomised placebo-controlled study, single-centre experience

Management of stent-related symptoms with the use of α-blockers: A meta-analysis

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