Presentation Authors: Maniyur Raghavendran*, Keyur Patel, Milan Joshi, Mysore, India
Introduction: Stent related symptom is one of the most discomforting situation after performance of ureteroscopic lithotripsy. It has resulted in indiscriminate use of opioids as a means of pain relief. Prelimnary studies showed promising results with Solifenacin alone in enhanced dose. In order to further pain relief, combination of solifenacin with either alpha blocker Tamsulosin or with Mirabgeron was thought of. This study is an effort in this direction whether combination is better than Solifenacin alone. Also stent causes severe lower urinary tract symptoms, which are equally troublesome but neglected when compared to pain. So, we wanted to see whether combination treatment is effective in relieving this discomforting symptom.
Methods: 150 patients undergoing Ureteroscopic lithotripsy were included for the study. 50 patients were randomly allocated to recieve Solifenacin 20 mg/ day, Solifenacin with Tamsulosin 0.4 mg,and Solifenacin with Mirabgeron 25 mg a day. All the groups were correctly matched with no confounding variables. The main compartive features noted were the amount of pain relief and the relief from lower urinary tract symptoms among the three groups. Statistical analysis were done by an experienced statistician.
Results: Results were tabulated. Table 1 describes descriptive features of pain. Table 2 depicts statistical differences between 3 groups. Table 3 compares improvement in LUTS among 3 groups.
Conclusions: Combination of Solifenacin enhanced dose with Mirabgeron gives the best pain relief among all the agents. A combination of Solifenacin with Tamsulosin gives the patient maximum relief from lower urinary tract symptoms.The combination treatments are safe and effectively tolerated. These combinations will go a long way to prevent the misuse of Opioids for post-operative pain relief.