scholarly journals Metal self-expandable covered temporary urethral stent Allium in patients with irreversibile uroobstruction: Ten-year experience

2014 ◽  
Vol 61 (3) ◽  
pp. 19-24
Author(s):  
Ana Mladenovic ◽  
Daniel Yachia ◽  
Biljana Markovic ◽  
Perica Adnadjevic
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Late Complications ◽  
Stent Insertion ◽  
Urinary Flow ◽  
Bulbar Urethra ◽  
Volume Measurements ◽  
Procedural Complications ◽  
Urethra Stricture ◽  
Lower Urinary

Aim of this study is to judge effectiveness of new design, temporary, cover, metal selective urethral Allium stents in lower urinary tract symptoms treatment concerning all peri and post procedural complications. Material and methods: We observed group of 40 patients with longstanding history of lower urinary tract symptom, in which outflow obstruction was localized in bulbar urethra in 24 pts and in prostatic urethra in 13 pts. Residual voiding volume and prostate volume measurements by ultrasonography, urethrocystography, urine culture and uroflowmetry (bulbar urethra stricture PTS) were done before stent insertion. Procedure was done in all cases but one in ambulatory conditions, under local anesthesia with oral antibiotics administration day before and 5 days after. Objective and subjective parameters of stent effectiveness were estimated and statistically revealed. Results: Majority of pts (32/40) were satisfied with all the aspects of the procedure and with quality of life while urethra was stented. Urinary infection did not happen in any case, encrustation of the migrated stent occurred in 2 cases (6,4%). Emptying of the bladder was adequate while wearing either prostatic or bulbar urethra stent. Residual volume was significantly smaller, urinary flow significantly higher. In pts with bulbar urethra stricture urinary flow and morphology of patent urethra lumen, 6 months after stent extraction suggested prolonged-permanent recanalisation results. Conclusion: Site specific, metal Allium urethral stents enable adequate emptying of the urinary bladder with minimal and transient patient discomfort. Stent insertion and explantation are simple procedures to perform, when correctly indicated without significant early and late complications.

Efficacy of cystone versus tamsulosin in treatment of stent-related lower urinary tract symptoms

2021 ◽  
pp. 205141582110002
Author(s):  
Mohammad Ali Ghaed ◽  
Reza Rezaei ◽  
Amineh Shafeinia ◽  
Robab Maghsoudi
Keyword(s):  
Urinary Tract ◽  
Symptom Score ◽  
Lower Urinary Tract Symptoms ◽  
International Prostate Symptom Score ◽  
Lower Urinary Tract ◽  
Visual Analogue Score ◽  
Stent Insertion ◽  
Double J Stent ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Objective: Double-J stent is a common tool used in urological procedures that is inserted for 2–6 weeks, but it may induce abdominal and flank pain, incontinence and irritative urinary symptoms. Alleviation of such symptoms would be useful to improve the patients’ quality of life. Accordingly, in this study, the efficacy of cystone versus tamsulosin in the treatment of double-J stent-related lower urinary tract symptoms was determined. Materials and methods: In this randomised clinical trial, 128 patients who required double-J stent insertion after transureteral lithotripsy during 2018–2019 were enrolled. They were randomly assigned to receive either cystone, tamsulosin, both, or placebo. The international prostate symptom score and visual analogue score data were recorded at baseline, after 2 and 4 weeks across the groups. Results: The international prostate symptom score and visual analogue score factors were statistically different across the case groups receiving cystone, tamsulosin and both drugs versus placebo ( P=0.001). Two weeks after drug administration, the visual analogue score and international prostate symptom score were not statistically different in the tamsulosin, cystone and dual therapy groups; however, after 4 weeks the cystone group had the lowest symptoms. Conclusion: Both tamsulosin and cystone are efficient drugs which would relieve stent-related lower urinary tract symptoms. The administration of cystone with or without tamsulosin for 4 weeks may have the best result in reducing the visual analogue score and international prostate symptom score. Level of evidence: Level I, 1b, therapeutic study, randomised controlled trial

Urodynamic 4D-CT evaluation: 320-row area detector CT scanner combined with PhyZiodynamics software analysis provides an innovative system to evaluate urinary flow and outlet obstructions

2019 ◽  
Vol 61 (4) ◽  
pp. 558-567
Author(s):  
Shintaro Mori ◽  
Hideki Yashiro ◽  
Masanori Inoue ◽  
Kiyoshi Takahara ◽  
Mamoru Kusaka ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Urinary Flow ◽  
Ct Scanner ◽  
4D Ct ◽  
Software Analysis ◽  
Area Detector ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

Background Evaluation of the morphology of the lower urinary tract as well as the movements associated with urination are required for the symptomatic diagnosis of lower urinary tract obstruction as well as the assessment of postoperative adaptation. However, no tool currently exists for direct and easy patient evaluation. Purpose To evaluate lower urinary tract obstruction and postoperative adaptation using a four-dimensional (4D) virtual reality urination image (urodynamic 4D-CT image). Material and Methods We used a 320-row area detector CT scanner and PhyZiodynamics image analysis software to perform 197 urodynamic 4D-CT examinations on 175 first-time patients between January 2014 and March 2017. Results A comparison of the obtained images before and after holmium laser enucleation of the prostate revealed the morphological changes due to prostate enucleation and enabled visualization of the ideal urination conditions, showing that the anatomical structural changes during urination and the opening of the urethra play a major role in improving voiding function. Conclusion Using low-dosage radiation, the sharply defined moving image obtained via urodynamic 4D-CT examination can be utilized as a physiological diagnostic tool to evaluate a series of urinary movements from any angle between the prostate, urethra, and bladder in a unitary manner with the time axis added. There was negligible patient impact. This technique could provide new opportunities for the diagnosis of lower urinary tract symptoms and post-surgical adaptation assessment.

scholarly journals Tadalafil 5 mg Alone or in Combination with Tamsulosin 0.4 mg for the Management of Men with Lower Urinary Tract Symptoms and Erectile Dysfunction: Results of a Prospective Observational Trial

2019 ◽  
Vol 8 (8) ◽  
pp. 1126 ◽  
Author(s):  
Arcangelo Sebastianelli ◽  
Pietro Spatafora ◽  
Jacopo Frizzi ◽  
Omar Saleh ◽  
Maurizio Sessa ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Urinary Tract ◽  
Combination Therapy ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Urinary Flow ◽  
Observational Trial ◽  
Paired Samples ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Tadalafil 5 mg represents the standard for men with Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS)/benign prostatic enlargement (BPE). We carried out an observational trial aiming to assess the efficacy and safety of Tadalafil compared with Tadalafil plus Tamsulosin. Seventy-five patients complaining of ED and LUTS were treated for 12-weeks with Tadalafil plus placebo (TAD+PLA-group) or with combination therapy tadalafil plus tamsulosin (TAD+TAM-group). Efficacy variables were: International Index of Erectile Function (IIEF), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax) and safety assessments. Data were evaluated using paired samples T-test (baseline vs. 12-weeks) and analysis of variance (Δgroup-TAD+PLA vs. Δgroup-TAD+TAM). At baseline, both groups presented similar characteristics and symptoms scores (all: p > 0.05). From baseline to 12-weeks, all the subjects showed a significant improvement of IIEF, total-IPSS, storage-IPSS, Qmax (all: p < 0.001). Conversely, a significant improvement of voiding-IPSS was observed in TAD+TAM-group (−3.5 points, p < 0.001). Indeed, TAD+PLA-group showed a not significant improvement of voiding-IPSS (−2.0 points, p = 0.074). When we compared between-groups differences at 12-weeks, IIEF (p = 0.255), total-IPSS (p = 0.084) and storage-IPSS (p = 0.08) did not show any statistically significant differences, whereas, voiding-IPSS and Qmax were significantly better in TAD+TAM-group (p = 0.006 and p = 0.027, respectively). No severe treatment adverse events (TAEs) were reported in both groups. Tadalafil achieved the same improvements of IIEF, total-IPSS, storage-IPSS when compared to combination therapy. Instead, Qmax and voiding-IPSS were better managed with combination therapy, without change of TAEs.

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