Eswl for Upper Ureteric Stone With and Without JJ Stent-A Comparative Study

Objective: To find out the outcome of stenting before ESWL in the management of upper ureteric stone. Methods and materials: This prospective comparative study was conducted in the department of urology, Sylhet Osmani Medical College Hospital from January 2011 to June 2012. Sixty two patients with upper ureteric stone, aged between 18 to 60 years irrespective of sex, unilateral radio opaque upper ureteric stone of greatest diameter 2cm, patients with normal renal function and negative urine culture and were agreed to participate in the study were selected. Selected 62 patients with upper ureteric stones were divided randomly into group-A and group-B each consisting 31 patients. The patients of group-A were treated with ESWL with a JJ stent and that of group-B without JJ stent. In the patients selected for JJ placement, a 5 fr JJ stent was placed under regional anaesthesia before ESWL. Siemens Lithotripsy ESWL machine was used to impart shock waves and 3500 shockwaves was given in a session. Both the groups were compared for stone clearance, ureteric colic, steinstrasse, fever, lower urinary tract symptoms (LUTS), number of ESWL sessions. Data were processed and analyzed using software SPSS. Results: The number ESWL session in stented group [single session 10 (32.3%) and multiple sessions 21 (67.7%)] and in non-stented group [single session 9 (29.0%) and multiple sessions 22 (71.0%)] was similar in both groups (p>0.05) Stones were cleared in 23 (74.2%) patients in stented group and 25 (80.6%) patients in non-stented group. Difference was not statistically significant (p>0.05). Ureteric colic was significantly fewer in stented group than that of non-stented group [4 (12.9%) vs 11 (35.5%); p<0.05] but surapubic pain was significantly more in stented group than that of non-stented group [13 (41.9%) vs 5 (16.1%); p<0.05]; while steinstrasse [3 (9.7%) vs 5 (16.1%); p>0.05] and fever [5 (16.1%) vs 2 (6.5%); p>0.05] did not differ statistically significant between groups. Lower urinary tract symptoms such as urinary frequency [15 (48.4%) vs 3 (9.7%); p<0.01]; urgency [17 (54.8%) vs 5 (16.1%); p<0.01] and dysuria [19 (61.3%) vs 6 (19.4%); p<0.01] were significantly more in stented group than that of non-stented group; but gross haematuria [21 (67.7%) vs 15 (48.4%); p>0.05] were more in stented group. Conclusion: ESWL is an effective and reasonable initial therapy in the management of upper ureteric stones measuring <2 cm. Pre-ESWL ureteric stenting provides no additional benefit over non-stented ESWL in their management. Moreover, stents are associated with signiûcant patient discomfort and morbidity. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2014 p.17-22

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Continuous versus Intermittent Tamsulosin Therapy in Men with Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia: A Randomized Control Trial

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v15i1.48635 ◽

2020 ◽

Vol 15 (1) ◽

pp. 22-26

Author(s):

SM Shameem Waheed ◽

Mohammad Abdur Rakib ◽

Md Shahidul Islam ◽

Mohammad Abdur Rakib ◽

Md Ashif Chowdhury ◽

...

Keyword(s):

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Prostatic Hyperplasia ◽

Urinary Tract Symptoms ◽

Significant Difference ◽

Group A ◽

Group B ◽

Lower Urinary

Introduction: Benign prostatic hyperplasia (BPH) is the most common benign tumour in men. About 50% of men at the age of 50 years develop BPH and about half of them report to the doctors with some form of lower urinary tract symptoms (LUTS). Objectives: To see the therapeutic effect of Tamsulosin on alternate day administration in comparison to daily dose for men who had been suffering from LUTS due to BPH. Materials and Methods: This clinical trial was carried out at Combined Military Hospital, Dhaka in a consecutive fashion for about 18 months. A total of 152 patients were selected from outpatient department and after assessing them through inclusion and exclusion criteria and grouped randomly in three groups Group-A (50 patients), Group-B (50 patients) and Group C (52 patients); all the patients were treated with Tablet Tamsulosin (0.4mg) daily for first three months. Then next 15 months they were treated as; Group-A received Tablet Tamsulosin (0.4mg) daily, Group-B received Tablet Tamsulosin (0.4mg) every alternate day and Group C received placebo Tablet (Folic acid 5 mg) daily. Data were collected at the beginning and end of 3rd month, 4th month, 7th month and 18th month of study, in the form of international prostate symptom score (IPSS), maximum urinary flow per second (Qmax) and post-voidal residue (PVR). Results: This study showed that at the initial three month, IPSS score declined in all three groups, Qmax improved and PVR reduced in all groups. In next phase of study; in Group-A patient there was progressive and significant improvement of all parameters (IPSS, Qmax and PVR) at the end of study. In Group-B patient also showed similar result at the end of study. In Group-C patient showed statistically significant difference in outcome in relation to Group-A and Group-B i.e. more in IPSS, less in Qmax and increase in PVR. Conclusion: With this study it is clearly evident that tamsulosin (0.4mg) therapy significantly improves symptoms of men suffering for LUTS due to BPH. And alternate day therapy having similar therapeutic outcome in relation to every day therapy. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 22-26

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Efficacy of Alpha Blockers in Relieving Symptoms of JJ Stent

10.47363/jsar/2021(2)115 ◽

2021 ◽

pp. 1-5

Author(s):

Hassan Mansoor ◽

◽

Kashif Bangash Bangash ◽

Syed Muhammad Kamran Majeed ◽

Hassan Mumtaz ◽

...

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Postoperative Period ◽

Lower Urinary Tract ◽

Control Group ◽

Alpha Blockers ◽

Urinary Tract Symptoms ◽

Group A ◽

Group B ◽

Lower Urinary

Introduction: JJ stenting has been routinely used in endourology with a wide variety of implications. These stents have beneficial effects in postoperative period improving surgical outcome. Though they are widely used in urology practice, JJ stents cause lower urinary tract symptoms (LUTS) in majority of patients. The objective of this study was to test the hypothesis that alpha blockers reduce lower urinary tract symptoms (LUTS) after rigid ureterorenoscopy in postoperative time period up to 3 weeks. Study Design: It was a randomized clinical trial (RCT). Setting: The study was conducted in KRL hospital, Islamabad. Patients presenting in outpatient / emergency department were selected for the study. Duration of Study: Six months (15th July 2016 to 15th Jan’ 2017) Methods: A prospective randomized study was conducted in total 100 patients undergoing rigid ureterorenoscopy (URS). Patients were randomized into an intervention Group A and Control Group B. In Group A tamsulosin 0.4mg was given after rigid ureterorenoscopy, while in Group B no tamsulosin was given except placebo. Primary outcome were lower urinary tract symptoms (LUTS), which were measured by international prostate symptoms score (IPSS) up to 3 weeks postoperatively. Results: The mean IPSS at 3rd week in postoperative phase of rigid URS for Group A was 4.76± 4.14315 and in Group B was 27.28 ± 5.03879 with the P value of 0.0001 which was statistically significant and also less than 0.05. So IPSS was statistically lower in Group A as compared to Group B up to 3 weeks post operatively. In conclusion, a significant statistical difference was found for Double J (DJ) stent related symptoms between the two groups. Conclusion: Alpha blockers reduce lower urinary tract symptoms (LUTS) in postoperative period of rigid ureterorenoscopy up to 3 weeks.

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COMPARISON OF SOLIFENACIN VERSUS COMBINATION OF SOLIFENACIN AND TAMSULOSIN IN IMPROVING UNILATERAL DOUBLE-J STENT RELATED LOWER URINARY TRACT SYMPTOMS - A PROSPECTIVE RANDOMIZED CONTROL TRIAL

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.2617 ◽

2021 ◽

Vol 71 (1) ◽

pp. 45-50

Author(s):

Muhammad Tanveer Sajid ◽

Sami Ur Rehman ◽

Muhammad Akmal ◽

Hussain Ahmad ◽

Zahoor Iqbal Mirza ◽

...

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Armed Forces ◽

P Value ◽

Cross Sectional ◽

Urinary Tract Symptoms ◽

Group A ◽

Group B ◽

Lower Urinary

Objective: To compare Solifenacin versus solifenacin plus tamsulosin in terms of international prostate symptom score (IPSS) for lower urinary tract symptoms (LUTS) in patients with unilateral double-J (DJ) ureteric stents. Study Design: Comparative cross sectional study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi from Sep 2018 to Feb 2019. Methodology: A total of two hundred (n=200) patients of either gender aged 20-50 years, who underwentunilateral DJ stenting for different endourological procedures, were enrolled after satisfying inclusion/exclusioncriteria and then randomly allocated to group A (Solifenacin 5mg once daily (OD) ± placebo for 2 weeks) or group B (Solifenacin 5mg OD ± Tamsulosin 0.4 mg OD for 2 weeks) respectively. Baseline (1st post-operative day) and Post 02 weeks treatment IPSS was recorded and analyzed. Results: Mean age of presentation in group A and group B was 41.11 ± 6.45 vs 39.86 ± 5.34 years with p-value 0.14. Majority of patients in both groups were male (34% female in group A while 31% in group B, difference being statistically insignificant p 0.65). Baseline IPSS in group A and group B was 10.33 ± 2.72 vs 10.46 ± 3.12 with pvalue 0.76 (statistically insignificant) while post 02 weeks treatment IPSS in group A and B was 9.20 ± 2.67 vs 7.88 ± 2.63 respectively with p-value <0.001, the difference being statistically significant. Conclusions: Current study revealed significant advantage of combination therapy (solifenacin ± tamsulosin)compared with solifenacin monotherapy in lowering LUTS based on IPSS in patients having unilateral......

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PROSTATIC HYPERPLASIA;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.10.770 ◽

2017 ◽

Vol 24 (10) ◽

pp. 1560-1565

Author(s):

Muhammad Sheraz Javed ◽

Safdar Hassan Javed

Keyword(s):

Prostatic Hyperplasia ◽

Significant Response ◽

Age Group ◽

Urinary Tract Symptoms ◽

Prostate Size ◽

Group A ◽

Male Patients ◽

Comparative Results ◽

Group B ◽

Lower Urinary

Lower Urinary Tract Symptoms. Alpha-1 adrenoceptor antagonists are mostfrequently prescribed medical management for LUTS and among these tamsulosin andterazosin are the most common. Objectives: To access comparison of efficacy of tamsulosinand terazosin for management of LUTS due to prostatic hyperplasia in terms of InternationalProstate Symptom Score (IPSS). Place and duration: Study being conducted at Departmentof Urology and Kidney Transplantation, Allied Hospital, Faisalabad for period of 24 months from01-07-2014 to 30-06-2016. Methodology: 659 male patients enrolled in study and randomlyassigned to Group A (Patients being administered with tamsulosin) and Group B (Patients beingadministered with terazosin) and improvement in IPSS monitored over period of two weeks.Results: 659 patients enrolled with mean age+sd as 61.9+10.2 years. Group A includes 330patients while Group B include 329 patients. Among Group A, 250 patients showed significantimprovement in IPSS while in Group B, 215 patients showed significant response to medicalmanagement in terms of IPSS and both groups showed statistically comparative response.Statistical response of management also determined in terms of variables of IPSS severity,prostatic size and age of patient and found that efficacy of the two groups were statisticallycomparable for patients with mild IPSS while in patients with moderate IPSS has response totreatment with tamsulosin but no statistical association of efficacy for treatment with terazosin.No statistical response was found for improvement in symptoms in cases with severe IPSS ineither groups. When response monitored in terms of prostate size in both groups, it was foundthat both groups have statistical response when prostate size is less than 35 grams, between35-55 grams but in case when prostate size was more than 55 grams, no statistical responsewas found with group B patients. When response was measured in terms of variable of age,results were consistent with the fact that statistically significant response of efficacy was foundin either groups for age group 45-55 years and 56-65 years but no statistical response wasfound for Group B when considered for age group more than 65 years. Conclusion: Based onresults it is concluded that both tamsulosin and terazosin has got comparative results in overallresponse. However, tamsulosin has superiority in treatment when IPSS is moderate, prostatesize is more than 55 grams and age of patient is more than 65 years.

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Management of JJ stent-related symptoms

Acta chirurgica iugoslavica ◽

10.2298/aci1401073p ◽

2014 ◽

Vol 61 (1) ◽

pp. 73-74 ◽

Cited By ~ 6

Author(s):

Athanasios Papatsoris ◽

Athanasios Dellis ◽

George Daglas ◽

Francesco Sanguedolce

Keyword(s):

Lower Urinary Tract ◽

Channel Blockers ◽

Efficacy And Safety ◽

Routine Procedure ◽

Alpha Blockers ◽

Validated Questionnaires ◽

Urinary Tract Symptoms ◽

Jj Stent ◽

Lower Urinary ◽

The Ideal

Ureteric JJ stents are inserted in numerous patients as a routine procedure. Nevertheless, the ideal JJ stent that does not cause any lower urinary tract symptoms has not been developed yet. Even special validated questionnaires have been used for the assessment of JJ stent-related symtoms. For the management of such symptoms usually alpha-blockers are administered. Also, studies have examined the efficacy and safety of anticholinergics and calcium channel blockers. In this article we review the literature upon the management of JJ stent-related symptoms.

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Drug treatment of bothersome lower urinary tract symptoms after ureteric JJ-stent insertion: A contemporary, comparative, prospective, randomised placebo-controlled study, single-centre experience

Arab Journal of Urology ◽

10.1016/j.aju.2016.08.004 ◽

2016 ◽

Vol 14 (4) ◽

pp. 262-268 ◽

Cited By ~ 3

Author(s):

Ihab A. Hekal

Keyword(s):

Urinary Tract ◽

Drug Treatment ◽

Lower Urinary Tract ◽

Controlled Study ◽

Stent Insertion ◽

Single Centre ◽

Urinary Tract Symptoms ◽

Single Centre Experience ◽

Jj Stent ◽

Lower Urinary

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Relationship between Lower Urinary Tract Symptoms and Prostatic Urethral Stiffness Using Strain Elastography: Initial Experiences

Journal of Clinical Medicine ◽

10.3390/jcm8111929 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1929

Author(s):

Jong Kyou Kwon ◽

Do Kyung Kim ◽

Joo Yong Lee ◽

Jong Won Kim ◽

Kang Su Cho

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Transitional Zone ◽

Midsagittal Plane ◽

Strain Elastography ◽

Urinary Tract Symptoms ◽

Relevant Variables ◽

Group B ◽

Lower Urinary

We attempted to visualize the periurethral stiffness of prostatic urethras using strain elastography in the midsagittal plane of transrectal ultrasonography (TRUS) and to evaluate periurethral stiffness patterns in relation to lower urinary tract symptoms (LUTS). A total of 250 men were enrolled. The stiffness patterns of the entire prostate and individual zones were evaluated using strain elastography during a TRUS examination. After excluding 69 men with inappropriate elastography images, subjects were divided according to periurethral stiffness into either group A (low periurethral stiffness, N = 80) or group B (high periurethral stiffness, N = 101). There were significant differences in patient age (p = 0.022), transitional zone volume (p = 0.001), transitional zone index (p = 0.33), total international prostate symptom score (IPSS) (p < 0.001), IPSS-voiding subscore (p < 0.001), IPSS-storage subscore (p < 0.001), and quality of life (QoL) score (p = 0.002) between groups A and B. After adjusting for relevant variables, significant differences in total IPSS, IPSS-voiding subscore, and QoL score were maintained. Men with high periurethral stiffness were associated with worse urinary symptoms than those with low periurethral stiffness, suggesting that periurethral stiffness might play an important role in the development of LUTS.

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Tribulus terrestris versus placebo in the treatment of erectile dysfunction and lower urinary tract symptoms in patients with late-onset hypogonadism: A placebo-controlled study

Urologia Journal ◽

10.1177/0391560318802160 ◽

2018 ◽

Vol 86 (2) ◽

pp. 74-78 ◽

Cited By ~ 2

Author(s):

Sameh Fayek GamalEl Din ◽

Mohamed Ahmed Abdel Salam ◽

Mohamed Shokr Mohamed ◽

Ahmed Ragab Ahmed ◽

Ahmed Tarek Motawaa ◽

...

Keyword(s):

Erectile Dysfunction ◽

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Tribulus Terrestris ◽

Androgen Deficiency ◽

Urinary Tract Symptoms ◽

Group A ◽

The Mean ◽

Lower Urinary

Aging is associated with a series of morphological and functional modifications that leads to reduced physiological efficiency and atrophy of various organs and systems. Tribulus terrestris induces its effect in fertility and sexual functions through the steroidal saponins, particularly the dominant saponins protodioscin. We aimed in this study to evaluate the efficacy and safety profiles of Tribulus terrestris in aging males with partial androgen deficiency who suffered from erectile dysfunction and lower urinary tract symptoms. A total of 70 randomized aging patients with erectile dysfunction and lower urinary tract symptoms were recruited from June 2017 to March 2018 from our andrology outpatient clinic. Thirty-five patients (group A) received Tribulus terrestris three times daily for 3 months and the other 35 patients (group B) received placebo. The mean of aspartate transaminase was elevated in group A after 3 months of receiving Tribulus terrestris (26.5 (before), 27.8 (after), respectively, p = 0.03). Moreover, there were significant elevations in the means of both total testosterone together with the score of the validated Arabic index of erectile function (5-item version of the International Index of Erectile Function) (2.2, 10.7 (before), 2.7, 16.1 (after), p < 0.001, p < 0.001, respectively). Finally, the mean of the total prostate-specific antigen was elevated in this group (1.4 (before), 1.7 (before), p = 0.007, respectively). Interestingly, there were no worsening of the lower urinary tract symptoms in group A as there was no change in the mean score of the international prostate symptom score, which was used to assess these symptoms before and after treatment (mean 14.4 (before), 14.6 (after), p = 0.67, respectively). In sum, this study replicates the findings of previous reports about the robust effect of this herbal medicine in elevating the testosterone level and improving the sexual function of patients who suffered from erectile dysfunction with partial androgen deficiency.

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