Study design, materials and methods
From September 2016 to September 2017, total 44 patients underwent double-J ureteral stent insertion following URSL were recruited from a tertiary medical center and received Oxybutynin postoperatively. Another 41 subjects without Oxybutynin therapy were enrolled as a control group. The clinical data including stone and stent characteristics and operation time were recorded at admission.
.All patients were anesthetized spinally or intravenously. The calculi were completetly disintegrated with Holmium-YAG laser. A double-J ureteral stent was indwelled at the end of the operation and the size and length of stent were chosen according the body height or the operator’s preference. All the stents were made of polyurethane and manufactured by Cook Urological (Cook Ireland Ltd). All the indwelled Foley catheter was removed within 24 hours after URSL. All procedures were completed uncomplicatedly (no ureteral injury or intraoprative stone migration to kidney)
All patients completed a validated, structured questionnaire assessing the stent-related lower urinary tract symptoms, body pain and hematuria two weeks after operation. The severity of stent-related symptoms was compared between two groups and for both genders
Statistical analysis was performed using the chi- square and t test, as appropriate. The results were considered significant at P <0.05.
The numerical data (age, height, weight, and symptom scores of frequency, urgency, urgent incontinence, nocturia, flank pain, abdominal pain, urethral pain and hematuria) were compared with t tests. Chi-square or Fisher’s exact test was utilized for the categorical data, including gender, stone position, stone laterality, stent diameter, and the completeness of proximal and distal curl. Two-sided tests were used, and a p value < 0.05 was considered to be significant.
Results
The mean age, stone characteristics, stent size, position and curl completeness were all comparable for both groups. Compared to the control group, Oxybutynin cohort had significantly less total symptom scores, item urgency and urgent incontinence subscore. As for stent related body pain, Oxybutynin group had significantly less flank, abdominal, urethral pain and hematuria (all p < 0.001). For Oxybutynin groups of both genders, total symptom scores, item urgent, urgent incontinence and hematuria subscore were all significantly lower than the control group (all p <0.001). Four subjects had minor adverse event and one AUR was encountered following Oxybutynin.
Interpretation of results
Oxybutynin cohort had significantly less total symptom scores, item urgency and urgent incontinence subscore. As for stent related body pain, Oxybutynin group had significantly less flank, abdominal, urethral pain and hematuria .
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