Korean J Urol.  2010 Sep;51(9):636-641.

Stent Position Is More Important than alpha-Blockers or Anticholinergics for Stent-Related Lower Urinary Tract Symptoms after Ureteroscopic Ureterolithotomy: A Prospective Randomized Study

• Lee SJ
• Yoo C
• Oh CY
• Lee YS
• Cho ST
• Lee SH
• Yang DY
• Lee SK
• Cho JS

Abstract

PURPOSE
To evaluate the clinical factors that impact ureteral stent-related lower urinary tract symptoms (LUTS) after ureteroscopic ureterolithotomy, including the stent position and medication.
MATERIALS AND METHODS
Fifty-three patients who underwent ureteroscopic ureterolithotomy with indwelling a stent were distributed into three groups. On demand analgesics were given to the group 1 (n=18). Daily tamsulosin 0.2 mg was added for group 2 (n=15) and daily tamsulosin 0.2 mg and tolterodine 4 mg was added for group 3 (n=20). The patients were also subclassified into appropriate or inappropriate group according to stent position. All the patients completed a visual analogue scale (VAS) and International Prostate Symptom Score (IPSS) on the 1st and 7th postoperative days. The VAS and IPSS were analyzed according to the medication groups and the stent position.
RESULTS
In the appropriate stent potion group, only the storage symptom scores of groups 2 and 3 on the 1st postoperative day were significantly lower than those of the group 1 (p=0.001). This medication effect on LUTS was not observed in the inappropriate stent position group. In this group, total IPSS (p=0.015) and storage symptom scores (p=0.002) were higher than in the appropriate stent position group on the 7th postoperative day.
CONCLUSIONS
Correct placement of the stent was more important than medication for lessening stent-related storage symptoms.

Keyword

Adrenergic alpha-antagonists; Cholinergic antagonists; Ureteroscopy; Urinary catheterization; Urological manifestations

MeSH Terms

Adrenergic alpha-Antagonists
Analgesics
Benzhydryl Compounds
Cholinergic Antagonists
Cresols
Humans
Lower Urinary Tract Symptoms
Phenylpropanolamine
Prospective Studies
Prostate
Stents
Sulfonamides
Ureter
Ureteroscopy
Urinary Catheterization
Urological Manifestations
Tolterodine Tartrate
Adrenergic alpha-Antagonists
Analgesics
Benzhydryl Compounds
Cholinergic Antagonists
Cresols
Phenylpropanolamine
Sulfonamides

Figure

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  FIG. 1 The position of the ureteral stent. (A) The distal curling of the ureteral stent is positioned in the ipsilateral side. (B) The distal curling of the ureteral stent crossed the midline of the bladder.

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  FIG. 2 Study flow diagram.

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