Effect of perioperative tamsulosin on successful ureteral access sheath placement and stent-related symptom relief: A double-blinded, randomized, placebo-controlled study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Purpose

This study investigated the effect of administering tamsulosin before surgery on the successful insertion of a 12/14 French (F) ureteral access sheath (UAS) during the procedure, as well as the impact of preoperative and postoperative tamsulosin use on symptoms related to the ureteral stent.

Materials and Methods

This study was a randomized, single-center, double-blinded, placebo-controlled trial involving 200 patients who underwent unilateral retrograde intrarenal surgery. Patients received either tamsulosin (0.4 mg) or placebo 1 week before surgery until stent removal. Patients were randomly assigned to one of four groups. Group 1 received tamsulosin throughout the study period. Group 2 received tamsulosin before surgery and placebo after surgery. Group 3 received placebo before surgery and tamsulosin after surgery. Group 4 received placebo before and after surgery. The USSQ (Ureteral Stent Symptom Questionnaire) was completed between postoperative days 7 and 14 immediately before stent removal.

Results

A total of 160 patients were included in this analysis. Their mean age was 55.0±11.0 years, and 48 patients (30.0%) were female. In the group that received preoperative tamsulosin, the success rate of 12/14F UAS deployment was significantly higher than that of the preoperative placebo group (88.0 vs. 75.3%, p=0.038). Preoperative and postoperative tamsulosin did not significantly alleviate symptoms related to the ureteral stent.

Conclusions

Our results revealed that preoperative administration of tamsulosin improved the success of larger-sized UAS, whereas preoperative and postoperative tamsulosin use did not significantly alleviate symptoms related to ureteral stents.

Related collections

Most cited references 30

Record: found
Abstract: found
Article: not found

Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery.

Olivier Traxer, Alexandre Thomas (2013)

The safety of using a ureteral access sheath during retrograde intrarenal surgery remains controversial. Using a novel classification, we prospectively evaluated the incidence and severity of ureteral access sheath driven ureteral wall injury after flexible ureteroscopy for retrograde intrarenal surgery. Data on a total of 359 consecutive patients who underwent retrograde intrarenal surgery for kidney stone were prospectively collected at 2 academic centers. We propose what is to our knowledge a novel endoscopic classification of iatrogenic ureteral wall injury. Ureteral injuries after retrograde intrarenal surgery were assessed visually with a digital flexible ureterorenoscope. The primary outcome measure was the incidence and nature of ureteral injuries. We sought factors predisposing to such injuries. Ureteral wall injury was found in 167 patients (46.5%). Severe injury involving the smooth muscle layers was observed in 48 patients (13.3%). Males vs females (p = 0.024) and older vs younger patients (p = 0.018) were at higher risk for severe ureteral access sheath related ureteral injury. The most significant predictor of severe injury was absent ureteral Double-J® stenting before retrograde intrarenal surgery (p <0.0001). Pre-stenting vs no pre-stenting decreased the risk of severe injury by sevenfold. Body mass index, a history of diabetes mellitus, vascular disease or abdominopelvic radiation therapy and operative time were not associated with severe ureteral injury. Ureteral access sheath use for retrograde intrarenal surgery should involve systematic visual assessment of the entire ureter to recognize severe ureteral injury. The incidence of severe ureteral injury is largely decreased by preoperative Double-J stenting. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

0 comments Cited 91 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Impact of COVID-19 on oncology clinical trials

Samik Upadhaya, Jia Xin Yu, Cristina Oliva … (2020)

0 comments Cited 63 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Indwelling ureteral stents: evaluation of symptoms, quality of life and utility.

H B Joshi, A Stainthorpe, R MacDonagh … (2003)

We report the prevalence of symptoms associated with ureteral stents, their impact on health related quality of life and utility analysis based on the validation studies of the new ureteral stent symptom questionnaire (USSQ). A total of 85 consecutive adult patients with unilateral indwelling ureteral stents who were asked to participate during the validation phases of the USSQ were considered for this analysis. They were asked to complete the USSQ and the EuroQol, a weighted utility instrument, 4 weeks after stent insertion and removal. In addition, 40 patients were asked to complete these questionnaires 1 week after stent insertion to assess the prevalence of symptoms and utility values at different times. Of the 85 patients 62 (73%) with a mean age of 50 years completed the necessary questionnaires. Urinary symptoms and pain that affected work performance and general health were important stent related problems. Of the patients 78% reported bothersome urinary symptoms that included storage symptoms, incontinence and hematuria. More than 80% of patients experienced stent related pain affecting daily activities, 32% reported sexual dysfunction, and 58% reported reduced work capacity and negative economic impact. The mean EuroQol utility values, which indicate patient satisfaction with treatment, were significantly reduced following stent insertion. Urinary symptoms and pain associated with indwelling ureteral stents interfere with daily activities and result in reduced quality of life in up to 80% of patients. Stents are associated with negative functional capacity and reduced utility values. The results have implications in terms of routine clinical practice, patient counseling and future stent research.

0 comments Cited 43 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Investig Clin Urol

Journal ID (iso-abbrev): Investig Clin Urol

Journal ID (publisher-id): ICU

Title: Investigative and Clinical Urology

Publisher: The Korean Urological Association

ISSN (Print): 2466-0493

ISSN (Electronic): 2466-054X

Publication date (Print): July 2024

Publication date (Electronic): 12 June 2024

Volume: 65

Issue: 4

Pages: 342-350

Affiliations

[1 ]Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

[2 ]Department of Urology, Ewha Womans University Mokdong Hospital, Seoul, Korea.

[3 ]Department of Urology, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea.

Author notes

Corresponding Author: Hyung Keun Park. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. TEL: +82-2-3010-3737, FAX: +82-2-477-8928, hkpark@ 123456amc.seoul.kr

^*Current affiliation: Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Author information

Kyeng Hyun Nam https://orcid.org/0000-0003-1372-3956

Jungyo Suh https://orcid.org/0000-0002-3867-4778

Jung Hyun Shin https://orcid.org/0000-0002-9399-5099

Han Kyu Chae https://orcid.org/0000-0002-3082-5842

Hyung Keun Park https://orcid.org/0000-0002-7607-4060

Article

DOI: 10.4111/icu.20240005

PMC ID: 11231658

PubMed ID: 38978214

SO-VID: 0200ec3b-c5a0-4e67-a1a0-d41a01f08e59

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 02 January 2024

Date revision received : 18 March 2024

Date accepted : 23 April 2024

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

Most referenced authors 277

See all reference authors

Effect of perioperative tamsulosin on successful ureteral access sheath placement and stent-related symptom relief: A double-blinded, randomized, placebo-controlled study

Read this article at

Abstract

Purpose

Materials and Methods

Results

Conclusions

Related collections

ChemSpider related publications

Most cited references 30

Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery.

Impact of COVID-19 on oncology clinical trials

Indwelling ureteral stents: evaluation of symptoms, quality of life and utility.

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Categories

Comments

Comment on this article

Similar content 518

Most referenced authors 277