Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
Department of Urology, Inje University Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea.
BJU Int. 2018 Nov;122(5):866-872. doi: 10.1111/bju.14416. Epub 2018 Jul 27.
To evaluate the effects of 50 mg mirabegron once daily for ureteric stent-related discomfort after ureteroscopic procedures by conducting a multicentre randomized study.
A total of 100 patients with indwelling ureteric stents after ureteroscopic stone removal or retrograde intrarenal surgery (RIRS) were randomized 1:1 to receive either no treatment or mirabegron during the stenting period. At the time of stent removal, the validated Ureteral Stent Symptom Questionnaire (USSQ), International Prostate Symptom Score (IPSS), total amount of analgesics administered, and post-voiding residual urine volume were reported for each patient.
Overall, 96 patients were enrolled for analysis. The postoperative USSQ body pain score (21.96 vs 13.96; P = 0.007) and overall pain score (5.58 vs 2.83; P = 0.002) were lower in the mirabegron group than in the control group. The USSQ urinary symptom scores (32.58 vs 27.92; P = 0.582) and USSQ general health score (17.71 vs 14.00; P = 0.281) were also lower in the mirabegron group, but the difference was not significant. Postoperative IPSS total scores and quality-of-life scores were lower in the mirabegron group, but the difference was not significant. The change in IPSS storage symptom score, however, was lower in the mirabegron group than in the control group (3.58 ± 3.58 vs 1.83 ± 4.39; P = 0.035). Post-void residual urine volume did not differ between the two groups (P > 0.05).
The use of 50 mg mirabegron once daily has the potential to reduce ureteric stent-related discomfort. Prospective larger-scale, placebo-controlled studies are warranted to further evaluate the beneficial effects of mirabegron on stent-related symptoms.
通过多中心随机研究评估每日一次口服 50mg 米拉贝隆治疗输尿管镜术后留置输尿管支架相关不适的效果。
共 100 例接受输尿管镜碎石术或逆行性肾内手术(RIRS)后留置输尿管支架的患者被随机分为 1:1 接受治疗或不治疗,在留置支架期间接受米拉贝隆治疗。在支架取出时,每位患者报告验证的输尿管支架症状问卷(USSQ)、国际前列腺症状评分(IPSS)、使用的镇痛药总量和排尿后残余尿量。
总体而言,96 例患者纳入分析。米拉贝隆组术后 USSQ 躯体疼痛评分(21.96 比 13.96;P=0.007)和总体疼痛评分(5.58 比 2.83;P=0.002)低于对照组。米拉贝隆组 USSQ 尿路症状评分(32.58 比 27.92;P=0.582)和 USSQ 一般健康评分(17.71 比 14.00;P=0.281)也较低,但差异无统计学意义。米拉贝隆组术后 IPSS 总分和生活质量评分较低,但差异无统计学意义。然而,米拉贝隆组的 IPSS 储存症状评分变化低于对照组(3.58 ± 3.58 比 1.83 ± 4.39;P=0.035)。两组间排尿后残余尿量无差异(P>0.05)。
每日口服 50mg 米拉贝隆可能减少输尿管支架相关不适。需要进行更大规模、安慰剂对照的前瞻性研究,以进一步评估米拉贝隆对支架相关症状的有益作用。