Moradi Mahmoudreza, Abdi Hossein, Ebrahimi Sina, Rezaee Haress, Kaseb Kaveh
Department of Urology in Imam Reza General Hospital & Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran.
SAGE Open Med. 2017 Feb 28;5:2050312117696436. doi: 10.1177/2050312117696436. eCollection 2017.
Ureteral double J stent are routinely applied for urologic patients although stent-related symptoms are common. Several attempts have been reported to minimize these symptoms.
To compare Tolterodine, Tamsulosin, and placebo effects on double J stent-related symptoms.
In all, 125 patients (82 males and 43 females) with double J stent were randomly divided into three groups (group 1, n: 42, group2, n: 40 and group 3, n: 43). Each patient randomly received one pack of drug in different colors by a nurse unaware of the content to take Tamsulosin 0.4 mg before sleep (MODALUSINE), Tolterodine 2 mg twice a day or placebo once daily (capsules filled with starch): group 1 received placebo, group 2 Tamsulosin and group 3 Tolterodine for 1 month in a double-blind manner. Ureteral stent-related morbidity indices which analyzed include urinary symptom, pain, general health, quality of work and sex scores. All of indices measured by Ureteral Symptom Score Questionnaire for first and fourth weeks after drug consumption and the first week after double J stent removal (labeled as w1, w4, and w5, respectively).
The mean age was 44.8 years (range: 15-83 years). There was no statistically significant difference in background characteristics between groups ( value > 0.05). The most important and statistically significant results were Tolterodine-reduced urinary symptom score ( value = 0.001) and improved general health score (p value = 0.007) of the fourth week. The pain score in groups of Tamsulosin and Tolterodine significantly reduced between weeks 4 and 1 and 5 and 1 (both with the p value < 0.05), but in other indices, there was no significant difference between them.
According to our results, we suggest Tolterodine to minimize stent-related urinary symptom and improve general health in patients with double J stent.
尽管输尿管双J支架相关症状很常见,但仍常规应用于泌尿外科患者。已有多项尝试旨在尽量减少这些症状。
比较托特罗定、坦索罗辛和安慰剂对双J支架相关症状的影响。
总共125例双J支架患者(82例男性和43例女性)被随机分为三组(第1组,n = 42;第2组,n = 40;第3组,n = 43)。每位患者由一名不知药物内容的护士随机发放一包不同颜色的药物,于睡前服用0.4毫克坦索罗辛(莫达非尼)、每日两次服用2毫克托特罗定或每日一次服用安慰剂(填充淀粉的胶囊):第1组服用安慰剂,第2组服用坦索罗辛,第3组服用托特罗定,为期1个月,采用双盲方式。分析的输尿管支架相关发病指数包括尿路症状、疼痛、总体健康、工作质量和性评分。所有指数均通过输尿管症状评分问卷在用药后第一周和第四周以及双J支架取出后第一周(分别标记为w1、w4和w5)进行测量。
平均年龄为44.8岁(范围:15 - 83岁)。各组间背景特征无统计学显著差异(p值> 0.05)。最重要且具有统计学显著意义的结果是,第四周时托特罗定降低了尿路症状评分(p值 = 0.001)并改善了总体健康评分(p值 = 0.007)。坦索罗辛组和托特罗定组的疼痛评分在第4周与第1周之间以及第5周与第1周之间均显著降低(p值均< 0.05),但在其他指数方面,两组之间无显著差异。
根据我们的研究结果,我们建议使用托特罗定以尽量减少双J支架患者的支架相关尿路症状并改善总体健康状况。