Dellis AE et al, 2014: Role of α-blockers in the Treatment of Stent-related Symptoms: A Prospective Randomized Control Study
Dellis AE, Keeley FX Jr, Manolas V, Skolarikos AA
Second Department of Surgery, University of Athens, Aretaieion Hospital, Chalandri, Athens, Greece
Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, United Kingdom
First Department of Urology, University General Hospital of Athens, Laiko Hospital, Athens, Greece
Second Department of Urology, University of Athens, Sismanoglio Hospital, Northern Athens, Greece
OBJECTIVE: To properly use the Ureteric Symptom Score Questionnaire (USSQ) to evaluate, in a randomized control study, the effect of 2 different α-blockers in improving symptoms and quality of life in patients with indwelling ureteral stents.
METHODS: After institutional review board approval, 150 consecutive patients with a double-J ureteral stent inserted after extracorporeal shockwave lithotripsy (ESWL) or ureteroscopic stone treatment were randomly assigned to receive tamsulosin 0.4 mg, alfuzosin 10 mg, or placebo. The validated USSQ was completed 1 and 4 weeks after stent insertion and 4 weeks after stent removal. The Kruskal-Wallis test for independent samples for non-normally distributed ordinal variables, chi-square to compare proportions or differences, and 1-way analysis of variance (ANOVA) for independent samples to compare for differences in case of continuous variables were used for statistical analysis of the results.
RESULTS: Patients receiving α-blockers expressed an overall statistically significant lower urinary (P <.001), pain (P
CONCLUSION: Stent-related morbidity is a reality in the majority of patients. Simple medications, such as α-blockers, reduce stent-related symptoms and the negative impact on quality of life. It seems that stent-related symptom improvement is independent to the type of α-blocker.
Urology. 2014 Jan;83(1):56-61. doi: 10.1016/j.urology.2013.08.067. Epub 2013 Nov 6.
PMID:24210570 [PubMed - in process]
2/3 of the 150 patients in this study were treated with SWL. The paper focusses not on SWL but on the stent related morbidity.
Lingeman et al. used the USSQ ( Lingeman JE, Preminger GM, Goldfischer ER, Krambeck AE; Comfort Study Team. Assessing the Impact of Ureteral Stent Design on Patient Comfort . J Urol. 2009 Jun;181(6):2581-7) and noticed "USSQ is a lengthy and complicated instrument."
The Ureteric Symptom Score Questionnaire (USSQ) could be downloaded from Bristol Urological Institute (BUI) in GB (Link BUI). Nowadays there is only a patients guide available on the website ( "Having a Ureteric Stent - What to Expect and How to Manage" Link Having a Ureteric Stent). It is good information for patients.