Upper Urinary Tract
A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: a prospective, randomised, double-blind, placebo-controlled trial
Correspondence: Michael J. Conlin, Oregon Health & Science University, Division of Urology and Renal Transplantation, CH 10U, 3303 Southwest Bond Avenue, Portland, OR 97239, USA.
What's known on the subject? and What does the study add?
- The problem of severe pain after ureteric stent removal, its incidence and prevention, has not been previously described.
- The present paper is the first to determine the incidence of severe pain after ureteric stent removal. It also shows that a single dose of NSAID before ureteric stent removal can prevent this pain in a significant number of patients.
- To determine the incidence of severe pain after ureteric stent removal.
- To evaluate the efficacy of a single dose of a non-steroidal anti-inflammatory drug (NSAID) in preventing this complication.
Patients and Methods
- A prospective, randomised, double-blind, placebo-controlled trial was performed at our institution.
- Adults with an indwelling ureteric stent after ureteroscopy were randomised to receive either a single dose of placebo or an NSAID (rofecoxib 50 mg) before ureteric stent removal.
- Pain was measured using a visual analogue scale (VAS) just before and 24 h after stent removal
- Pain medication use after ureteric stent removal was measured using morphine equivalents.
- In all, 22 patients were enrolled and randomised into the study before ending the study after interim analysis showed significant decrease in pain level in the NSAID group.
- The most common indication for ureteroscopy was urolithiasis (14 patients).
- The proportion of patients with severe pain (VAS score of ≥7) during the 24 h after ureteric stent removal was six of 11 (55%) in the placebo group and it was zero of 10 in the NSAID group (P < 0.01).
- There were no complications related to the use of rofecoxib.
- We found a 55% incidence of severe pain after ureteric stent removal.
- A single dose of a NSAID before stent removal prevents severe pain after ureteric stent removal.