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Abstract

EFFECT OF TWO DIFFERENT DOSES OF SOLIFENACIN SUCCINATE THERAPY (5MG, 10MG) FOR THE TREATMENT OF URETERAL STENT (DOUBLE J) RELATED SYMPTOMS IN COMPARISON TO PLACEBO.

Dr. Ayad Abdulkhaleq Ismael*

ABSTRACT

Introduction and aim of the study The double-J ureteral stent had been widely applied during the endourologic surgery to relieve or prevent ureteral obstruction.[1] Some of the patients might encounter stentrelated morbidities, such as lower urinary tract symptoms (LUTS), stent-related body pain and hematuria, which were bothersome and might have a negative impact on quality of life (QoL) and sexual performance for both genders.[2–4] The objective of this study is to evaluate the effects of two different doses of solifenacin (5mg, 10mg) on double-J stent-related symptoms following uncomplicated ureterosocpic lithotripsy (URSL). Patients and Method: A prospective study on a 3 groups of patients undergoing ureteroscopy in Rizgary Teaching hospital, first group of patients will receive 5 mg Solifenacin succinate after insertion of Double J stent(40 patients) and second group of patients will receive 10mg Solinenacin Succinate(40 patients), The third group of patient receiving only Placebo(40 patients), then these 3 groups of patients compared in the points of symptoms that related to Double j Stent. Ureteral Symptom Score Questionnaire (USSQ) was a validated, widely applied questionnaire for stent-related symptoms[13] is used. Results: Total symptom score in 10mg solifenacin group compared with 5mg group (8.62 ± 3.72 vs. 9.09 ± 3.91, p 0.91), urinary frequency score (2.53 ± 0.88 vs 2.55 ± 0.99, p 0.90), urgency score (0.48 ± 0.64 vs. 0.55 ± 0.64, p 0.55) and urgent incontinence score (0.08 ± 0.27 vs. 0.10 ± 0.30, p 0.71), Nocturia (1.75 ± 0.74 vs. 1.80 ± 0.72, p 0.75). For stent-related pain, also subjects in the both solifenacin groups had no significant differences, flank pain score (0.98 ± 0.80 vs. 1.03 ± 0.71, p 0.71), abdominal pain score (0.80 ± 1.04 vs. 0.80 ± 1.04, p 0.66), urethral pain score (1.05 ± 1.08 vs. 1.08 ± 1.02, p 0.91) and hematuria score (1.05 ± 1.11 vs. 1.18 ± 1.15, p 0.63). As compared to the placebo group, subjects in 5mg solifenacin group had significantly lower total symptom score (9.09 ± 3.91 vs. 16.31 ± 6.90, p<0.001), urgency score (0.55 ± 0.64 vs. 2.13 ± 0.85, p<0.001) and urgent incontinence score (0.10 ± 0.30vs. 0.8 ± 0.82, p<0.001). As for stent-related pain, subjects in the 5mg solifenacin group had significantly lower item flank pain score (1.03 ± 0.71 vs. 2.13 ± 0.88, p<0.001), abdominal pain score (0.80 ± 1.04 vs. 2.28 ± 1.06, p<0.01), urethral pain score (1.08 ± 1.02 vs. 2.23 ± 1.14, p<0.001) and hematuria score (1.18 ± 1.15 vs. 2.18 ± 1.10, p<0.001). subjects in 10mg solifenacin group had significantly lower total symptom score (8.62 ± 3.72 vs. 16.31 ± 6.90, p<0.001), urgency score (0.48 ± 0.64 vs. 2.13 ± 0.85, p<0.001) and urgent incontinence score (0.08 ± 0.27 vs. 0.8 ± 0.82, p<0.001). As for stent-related pain, subjects in the 10mg solifenacin group had significantly lower item flank pain score (0.98 ± 0.80 vs. 2.13 ± 0.88, p<0.001), abdominal pain score (0.80 ± 1.04 vs. 2.28 ± 1.06, p<0.01), urethral pain score (1.05 ± 1.08 vs. 2.23 ± 1.14, p<0.001) and hematuria score (1.05 ± 1.11 vs. 2.18 ±1.10, p<0.001). Total symptom score in 10mg solifenacin group compared with 5mg group (8.62 ± 3.72 vs. 9.09 ± 3.91, p 0.91), urinary frequency score (2.53 ± 0.88 vs 2.55 ± 0.99, p 0.90), urgency score (0.48 ± 0.64 vs. 0.55 ± 0.64, p 0.55) and urgent incontinence score (0.08 ± 0.27 vs. 0.10 ± 0.30, p 0.71), Nocturia (1.75 ± 0.74 vs. 1.80 ± 0.72, p 0.75). For stent-related pain, also subjects in the both solifenacin groups had no significant differences, flank pain score (0.98 ± 0.80 vs. 1.03 ± 0.71, p 0.71), abdominal pain score (0.80 ± 1.04 vs. 0.80 ± 1.04, p 0.66), urethral pain score (1.05 ± 1.08 vs. 1.08 ± 1.02, p 0.91) and hematuria score (1.05 ± 1.11 vs. 1.18 ± 1.15, p 0.63). Conclusions: For patients with ureteral calculi following URSL, postoperative 5mg solifenacin or 10mg solifenacin were effective and well tolerated for the treatment of stent-related symptoms in comparison to placebo, mainly urgency and urgent incontinence, stent-related body pain and hematuria among both genders with no significant differences between 5 and 10 mg in reliving symptoms.

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