Comparison of efficacy and tolerance of short-duration open-ended ureteral catheter drainage and tamsulosin administration to indwelling double J stents following ureteroscopic removal of stones.

OBJECTIVES

To evaluate the efficacy of short-duration, open-ended ureteral catheter drainage as a replacement to indwelling stent, and to study the effect of tamsulosin on stent-induced pain and storage symptoms following uncomplicated ureteroscopic removal of stones.

DESIGN

Prospective randomised study.

SETTING

School of Medical Sciences and Research, Sharda University, Greater Noida, India.

PATIENTS: Patients who underwent ureteroscopic removal of stones for lower ureteral stones between November 2011 and January 2014 were randomly assigned into three groups. Patients in group 1 (n=33) were stented with 5-French double J stent for 2 weeks. Patients in group 2 (n=35) were administered tablet tamsulosin 0.4 mg once daily for 2 weeks in addition to stenting, and those in group 3 (n=31) underwent 5-French open-ended ureteral catheter drainage for 48 hours.

MAIN OUTCOME MEASURES: All patients were evaluated for flank pain using visual analogue scale scores at days 1, 2, 7, and 14, and for storage (irritative) bladder symptoms using International Prostate Symptom Score on days 7 and 14, and for quality-of-life score (using International Prostate Symptom Score) on day 14.

RESULTS

Of the 99 patients, visual analogue scale scores were significantly lower for groups 2 and 3 (P<0.0001). The International Prostate Symptom Scores for all parameters were lower in patients from groups 2 and 3 compared with group 1 both on days 7 and 14 (P<0.0001). Analgesic requirements were similar in all three groups.

CONCLUSION

Open-ended ureteral catheter drainage is equally effective and better tolerated than routine stenting following uncomplicated ureteroscopic removal of stones. Tamsulosin reduces storage symptoms and improves quality of life after ureteral stenting.