Single Dose Diclofenac and Tamsulosin Effectiveness in Patients Undergoing Double J-Stent Removal Under Local Anaesthesia
DOI:
https://doi.org/10.17140/UAOJ-6-141Keywords:
Diclofenac, Tamsulosin, DJ removalAbstract
Purpose
The purpose of this study was to see effectiveness of diclofenac sodium and tamsulosin combination on patients’ pain perception
after ureteral stent removal.
Materials and Methods
Study was carried out from October 2019 to March 2021. All patients with unilateral stent placement after renal or ureteric stone
endoscopic surgery were randomized in 3 groups. Group-A include 20 patients who were given placebo drug 2-hours prior to
double J (DJ) removal. Group-B included 20 patients who were given oral diclofenac 2-hours prior to DJ removal. Group-C
included 20 patients who were given oral diclofenac and tamsulosin 2-hours prior to DJ removal. All patients received 10 cc 2%
viscous lidocaine intraurethral before cystoscopy. No sedatives or analgesics were administered during the procedure. All patients
provided consent before the procedure and they were asked to record their pain experience on a visual analog pain scale as soon
as the procedure was finished. The pulse rate and systolic and diastolic blood pressure (BP) were also recorded 5-minutes before
the procedure and during the procedure
Results
General characteristic of age, gender and indication for DJ-stenting were comparable in all groups. The mean pain score on the
visual analogue scale (VAS) in Group-C was significantly lower than that in Group-A and B (p<0.001) A statistically significant
difference was found between the two groups in terms of anxiety scores after cystoscopy, intraoperative systolic BP and pulse rate.
Patients who were given oral diclofenac and tamsulosin two hours prior to DJ removal experienced less pain and anxiety.
Conclusion
Oral diclofenac plus tamsulosin combination prior to DJ removal improves patient’s comfort.
References
Lingeman JE, Preminger GM, Goldfischer ER, Krambeck AE; Comfort Study Team. Assessing the impact of ureteral stent design on patient comfort. J Urol. 2009; 181(6): 2581-2587. doi: 10.1016/j. juro.2009.02.019 Submit your article to this journal | https://openventio.org/submit-manuscript/ 7 Singh H, et al
Theckumparampil N, Elsamra SE, Carons A, et al. Symptoms after removal of ureteral stents. J Endourol. 2015; 29(2): 246-52. doi: 10.1089/end.2014.0432
Davies NM, Anderson KE. Clinical pharmacokinetics of diclofenac. Therapeutic insights and pitfalls. Clin Pharmacokinet. 1997; 33(3): 184-213. doi: 10.2165/00003088-199733030-00003
Tadros NN, Bland L, Legg E, Olyaei A, Conlin MJ. A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: A prospective, randomised, double-blind, placebo-controlled trial. BJU Int. 2013; 111(1): 101- 105. doi: 10.1111/j.1464-410X.2012.11214.x
Gangkak G, Teli RD, Yadav SS, Tomar V, Priyadarshi S, Aggarwal SP. A single oral dose of silodosin and diclofenac sodium is effective in reducing pain after ureteric stent removal: a prospective, randomized, double blind placebo-controlled study. Springerplus. 2016; 5: 23. doi: 10.1186/s40064-015-1662-7
Yuri P, Ali Z, Rasyid N, Birowo P. Effects of pipemidic acid, phenazopyridine HCL and sodium diclofenac on pain perception following endoscopic urological surgery: Double-blinded randomized-controlled trial. Acta Med Indones. 2016; 48(3): 184-192.
Hadibrata E, Farishal A, Ali Z, Danarto R. Tamsulosin and sodium Ddiclofenac as an effective therapy to reduce pain after ureteral stent removal: A prospective, double blinded randomized placebo controlled trial. Urol J. 2020; 18(1): 111-116. doi: 10.22037/ uj.v0i0.5190
Dellis A, Joshi HB, Timoney AG, Keeley FX Jr. Relief of stent related symptoms: Review of engineering and pharmacological solutions. J Urol. 2010; 184(4): 1267-1272. doi: 10.1016/j. juro.2010.06.043
Gupta M, Patel T, Xavier K, et al. Prospective randomized evaluation of periureteral botulinum toxin type A injection for ureteral stent pain reduction. J Urol. 2010; 183(2): 598-602. doi:
1016/j.juro.2009.10.021 10. Damiano R, Autorino R, De Sio M, Giacobbe A, Palumbo IM, D'Armiento M. Effect of tamsulosin in preventing ureteral stent-related morbidity: A prospective study. J Endourol. 2008; 22(4): 651- 656. doi: 10.1089/end.2007.0257
Rane A, Saleemi A, Cahill D, Sriprasad S, Shrotri N, Tiptaft R. Have stent-related symptoms anything to do with placement technique? J Endourol. 2001; 15(7): 741-745. doi: 10.1089/08927790152596352
Deliveliotis C, Chrisofos M, Gougousis E, Papatsoris A, Dellis A, Varkarakis IM. Is there a role for alpha1-blockers in treating double-J stent-related symptoms? Urology. 2006; 67(1): 35-39. doi: 10.1016/j.urology.2005.07.038 Original Research | Volume 6 | Number 1|
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Urology and Andrology (UA) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
