Title: Editorial Comment from Dr Kawahara to Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review
Abstract: International Journal of UrologyVolume 24, Issue 4 p. 260-260 Editorial CommentFree Access Editorial Comment from Dr Kawahara to Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review Takashi Kawahara M.D., Ph.D., Takashi Kawahara M.D., Ph.D. [email protected] Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, JapanSearch for more papers by this author Takashi Kawahara M.D., Ph.D., Takashi Kawahara M.D., Ph.D. [email protected] Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, JapanSearch for more papers by this author First published: 02 March 2017 https://doi.org/10.1111/iju.13316Citations: 5AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat At nearly five decades since the first reported use of a ureteral stent by Zimskind et al., various materials and coatings have been developed to prevent ureteral stent complications, such as encrustation, incrustation, migration and infection.1 Although there are still ureteral stent-related symptoms, including urgency, dysuria, pain and hematuria, there is no widespread consensus on how to reduce ureteral stent complications.2, 3 Betschart et al. carried out a systematic review of 107 articles on ureteral stent-related symptoms.4 The study suggested the effectiveness of alpha-1 blockers in reducing ureteral stent symptoms, and suggested that choosing an appropriate length of ureteral stent seemed beneficial for reducing symptoms. A network meta-analysis by Kwon et al. showed that alpha-1 blockers – especially tamsulosin and alfuzosin – reduced stent-related symptoms in seven randomized control studies.5 Due to the various methods of evaluating stent-related symptoms, including the International Prostate Symptom Score, overactive bladder symptoms score, visual analog pain scare and Ureteral Stent Symptoms Questionnaire, and the variety of stent forms (including the coating, caliber and length), it remains difficult to evaluate the stent-related complications in different published studies.6 Despite these limitations, the administration of alpha-1 blockers and the use of stents of an appropriate length might be good approaches for reducing ureteral stent-related pain based on this article. Further studies are required to confirm the evidence. Even now, ureteral stenting is a fundamental part of many urological procedures that are associated with stent-related symptoms. Ultimately, the way to reduce stent-related symptoms would be to make ureteral stenting unnecessary. Conflict of interest None declared. References 1Zimskind PD, Fetter TR, Wilkerson JL. Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J. Urol. 1967; 97: 840– 4. 2Singh I, Gupta NP, Hemal AK, Aron M, Seth A, Dogra PN. Severely encrusted polyurethane ureteral stents: management and analysis of potential risk factors. Urology 2001; 58: 526– 31. 3el-Faqih SR, Shamsuddin AB, Chakrabarti A et al. Polyurethane internal ureteral stents in treatment of stone patients: morbidity related to indwelling times. J. Urol. 1991; 146: 1487– 91. 4Betschart P, Zumstein V, Piller A, Schmid HP, Abt D. Prevention and treatment of symptoms associated with indwelling ureteral stents: a systematic review. Int. J. Urol. 2017; 24: 250– 9. 5Kwon JK, Cho KS, Oh CK et al. The beneficial effect of alpha-blockers for ureteral stent-related discomfort: systematic review and network meta-analysis for alfuzosin versus tamsulosin versus placebo. BMC Urol. 2015; 15: 55. 6Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J. Urol. 2003; 169: 1060– 4. Citing Literature Volume24, Issue4April 2017Pages 260-260 ReferencesRelatedInformation