SWL literature
SWL Literature
Reviewer's Choice 

Falahatkar S. et al., 2021: The effects of pregabalin, solifenacin and their combination therapy on ureteral double-J stent-related symptoms: A randomized controlled clinical trial

Falahatkar S, Beigzadeh M, Mokhtari G, Esmaeili S, Kazemnezhad E, Amin A, Herfeh NR, Falahatkar R.
Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Abstract

Background: Many medical therapies have been tested to deal with urinary stent-related symptoms (USRS). Several preventive and pharmaceutical methods have been already used for better compatibility of stents. However, the existing evidence for pharmacological treatment is still controversial. This study aims to evaluate the effects of pregabalin, solifenacin, and combination therapy on ureteral double-J stent-related symptoms following ureteroscopy and transureteral lithotripsy (TUL).

Materials and methods: In a randomized controlled clinical trial, from November 2017 to March 2019, 256 patients who underwent ureteroscopy were enrolled. Patients were randomly divided into four groups including: group A received pregabalin 75mg BID (twice daily), group B received solifenacin 5mg orally once daily, group C received combination of pregabalin and solifenacin and the group D (control) given no drugs.

Results: One hundred and fifty-one (58.9%) males and 101 (41.1%) females were enrolled in this study with a mean age of 43.47±7 (p=0.32, p=0.67). USSQ domains score such as urinary symptoms, pain, general condition, work performance, sexual matters and additional problems were significantly differenced during second and fourth week of follow-up among study groups (p <0.0001). In Tukey's multiple comparison test, urinary symptoms (p=0.735), pain (p=0.954) and sexual matters (p=0.080) in second week and work performance in forth week in group B was not significantly better than group D. Only group C in all indexes of USSQ showed significantly beneficial effects over group D (p <0.0001).

Conclusion: Combination therapy of pregabalin and solifenacin has a significant effect on stent-related symptoms and is preferred over monotherapy of the respected medications.
Int Braz J Urol. 2021 May-Jun;47(3):596-609. doi: 10.1590/S1677-5538.IBJU.2020.0848. PMID: 33621009. FREE ARTICLE

0
 

Commentaires 1

Hans-Göran Tiselius le mercredi 2 juin 2021 08:30

This article deals with medical treatment aiming at reduced discomfort of internal stents. Although the patients in this randomized study had the stents inserted after URS, the topic is of interest also for patients treated with SWL in whom internal stents might be used for several reasons:
a. SWL of large renal stones to avoid the problems of obstruction by steinstrasse
b. Decompression because of obstructing ureteral stones with or without infection.
c. Established steinstrasse
d. Prevention of obstruction in medically brittle patients
The pharmacological approach that had the best effect was when the two agents below were used in combination:
Pregabalin 75 mg x 2 (GABA; for example, Lyrica Pfizer)
Solifenacin 5 mg x 1 (muscarinic receptor antagonist; for example, Vesicare)

When the two agents were given as monotherapy the effect was not beneficial in comparison with the untreated control group. This information is indeed interesting and of clinical value because discomfort of stents is a common complaint.

Hans-Göran Tiselius

This article deals with medical treatment aiming at reduced discomfort of internal stents. Although the patients in this randomized study had the stents inserted after URS, the topic is of interest also for patients treated with SWL in whom internal stents might be used for several reasons: a. SWL of large renal stones to avoid the problems of obstruction by steinstrasse b. Decompression because of obstructing ureteral stones with or without infection. c. Established steinstrasse d. Prevention of obstruction in medically brittle patients The pharmacological approach that had the best effect was when the two agents below were used in combination: Pregabalin 75 mg x 2 (GABA; for example, Lyrica Pfizer) Solifenacin 5 mg x 1 (muscarinic receptor antagonist; for example, Vesicare) When the two agents were given as monotherapy the effect was not beneficial in comparison with the untreated control group. This information is indeed interesting and of clinical value because discomfort of stents is a common complaint. Hans-Göran Tiselius
Invité
mardi 27 juillet 2021

By accepting you will be accessing a service provided by a third-party external to https://storzmedical.com/

Linkedin Channel Facebook Channel Instagram Channel Twitter Youtube Channel