Prospective Randomized Evaluation of Periureteral Botulinum Toxin Type A Injection for Ureteral Stent Pain Reduction

Gupta, Mantu; Patel, Trushar; Xavier, Keith; Maruffo, Franzo; Lehman, Daniel S.; Walsh, R Matthew; Landman, Jaime

doi:10.1016/j.juro.2009.10.021

Cited by 55 publications

(27 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…55 This randomized, single-blind study showed a significant decrease in pain and less narcotic use in the treated group, whereas none of the USSQ subscores improved.…”

Section: Intravesical Instillations or Injectionsmentioning

confidence: 82%

Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review

et al. 2017

View full text Add to dashboard Cite

Temporary drainage of the upper urinary tract by internal ureteral stents is a routine procedure in endourology. However, it is associated with a clear side-effect profile. Our aim was to evaluate prevention and treatment options of stent-related symptoms. We carried out a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines using MEDLINE and SCOPUS, and identified 107 appropriate records. A high number of these studies showed clear methodological limitations. Available data clearly support the use of a 1 -blockers in patients suffering from stent-related symptoms. It seems that antimuscarinic monotherapy or combination with a 1 -blockers might also play an important role, whereas the use of classical analgesics in the treatment of stent-related symptoms has not been assessed systematically within clinical trials so far. Improvements in stent design and material seem to have the potential to reduce stent-related symptoms. However, so far there is no type of stent with outstanding characteristics and clear evidence suggesting fundamental advantages compared with a standard double pigtail stent. Although stent diameter does not seem to influence patients' comfort, it seems to be beneficial to choose a proper stent-length. Coated and drug-eluting stents, as well as intravesical drug application, seem to be promising concepts to prevent stent-related symptoms, but still have to be considered as experimental approaches. Furthermore, thorough patient education has the potential to reduce the morbidity associated with ureteral stenting. Further research in the field seems to be mandatory.

show abstract

“…55 This randomized, single-blind study showed a significant decrease in pain and less narcotic use in the treated group, whereas none of the USSQ subscores improved.…”

Section: Intravesical Instillations or Injectionsmentioning

confidence: 82%

Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review

et al. 2017

View full text Add to dashboard Cite

show abstract

“…If a ureteral stent is needed after endoscopic surgery, ureteral length should be measured so that an appropriate stent can be used in patients, which can reduce distal migration and stent-related symptoms [10]. Periureteral injection of botulinum toxin type A after stent insertion has been shown to decrease pain and narcotic requirement [11]. …”

Section: Discussionmentioning

confidence: 99%

Effects of Tamsulosin, Solifenacin, and Combination Therapy for the Treatment of Ureteral Stent Related Discomforts

Lim¹,

Kim²,

Lee³

et al. 2011

Korean J Urol

View full text Add to dashboard Cite

PurposeTo evaluate the effect of tamsulosin, solifenacin, and combination therapy of two agents in improving the lower urinary tract symptoms of patients with indwelling double-J ureteral stents.Materials and MethodsA total of 168 patients underwent placement of a double-J ureteral stent after retrograde ureteroscopy for urinary stone disease. All patients received polyurethane double-J ureteral stents (6 Fr, 24 or 26 cm), which were removed a mean of 14 days postoperatively. A total of 48 patients were given no medication (Group 1), 43 patients were given tamsulosin 0.2 mg once daily (Group 2), 45 patients were given solifenacin 5 mg once daily (Group 3), and 32 patients were given a combination of two agents postoperatively (Group 4). International Prostate Symptom Score/quality of life (IPSS/QoL) and visual analogue pain scale (VAPS) questionnaires were completed by each patient at 1 day postoperatively and on the day of stent removal.ResultsIn the total group of patients, the mean age was 50.24±12.90 years. There was a significant difference in the IPSS total score between group 1 and groups 3 and 4. Group 4 also differed significantly from group 1 in the irritative subscore. The obstructive subscore differed between groups 2 and 4 and group 1. There was a statistically significant difference between group 1 and group 4 in the QoL score. There were no significant differences in the VAPS.ConclusionsCombination therapy with tamsulosin and solifenacin improved both irritative and obstructive symptoms more than in the other groups. Combination therapy should be strongly considered for patients who complain of stent-related symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

2236 the Effects of Tamsulosin, Solifenacin and Combination Therapy for the Treatment of Ureteral Stent Related Discomforts

Park¹,

Park²,

Kwon³

et al. 2011

Journal of Urology

View full text Add to dashboard Cite

Purpose:To evaluate the effect of tamsulosin, solifenacin, and combination therapy of two agents in improving the lower urinary tract symptoms of patients with indwelling double-J ureteral stents. Materials and Methods: A total of 168 patients underwent placement of a double-J ureteral stent after retrograde ureteroscopy for urinary stone disease. All patients received polyurethane double-J ureteral stents (6 Fr, 24 or 26 cm), which were removed a mean of 14 days postoperatively. A total of 48 patients were given no medication (Group 1), 43 patients were given tamsulosin 0.2 mg once daily (Group 2), 45 patients were given solifenacin 5 mg once daily (Group 3), and 32 patients were given a combination of two agents postoperatively (Group 4). International Prostate Symptom Score/quality of life (IPSS/QoL) and visual analogue pain scale (VAPS) questionnaires were completed by each patient at 1 day postoperatively and on the day of stent removal. Results: In the total group of patients, the mean age was 50.24±12.90 years. There was a significant difference in the IPSS total score between group 1 and groups 3 and 4. Group 4 also differed significantly from group 1 in the irritative subscore. The obstructive subscore differed between groups 2 and 4 and group 1. There was a statistically significant difference between group 1 and group 4 in the QoL score. There were no significant differences in the VAPS. Conclusions: Combination therapy with tamsulosin and solifenacin improved both irritative and obstructive symptoms more than in the other groups. Combination therapy should be strongly considered for patients who complain of stent-related symptoms.

show abstract

Prospective Randomized Evaluation of Periureteral Botulinum Toxin Type A Injection for Ureteral Stent Pain Reduction

Abstract: Periureteral botulinum toxin type A injection improves ureteral stent tolerability by significantly decreasing postoperative pain and narcotic requirements. Improvement in irritative symptoms was not observed.

Cited by 55 publications

References 24 publications

Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review

Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review

Effects of Tamsulosin, Solifenacin, and Combination Therapy for the Treatment of Ureteral Stent Related Discomforts

2236 the Effects of Tamsulosin, Solifenacin and Combination Therapy for the Treatment of Ureteral Stent Related Discomforts

Contact Info

Product

Resources

About