Üreteral Stentlerin Postoperatif Ağrı Üzerine Etkisi

Year 2021, , 54 - 59, 30.01.2021

Mustafa Bilal Hamarat , Fatih Üstün , Serkan Özcan , Murat Bagcıoglu , Mehmet Kutlu Demirkol , Bekir Turgut

https://doi.org/10.21673/anadoluklin.778906

Abstract

Amaç: Çalışmamızda Double J (DJ) üreteral stentlerin endoskopik üreter taş tedavisi sonrası postoperatif ağrı üzerine olan etkisini değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Prospektif randomize çalışmamızda tek taraflı üreter taşı nedeniyle başarılı bir şekilde opera edilen ve DJ üreteral stent yerleştirilen 63 hasta çalışmaya dahil edildi. Hastalar yaşlarına göre 40 yaş üzeri ve 40 yaş altı olmak üzere iki alt grupta değerlendirildi. Bu alt gruplar da preoperatif çift kör olarak 4.8 fr ve 6 fr üreteral DJ stent yerleştirilen gruplar olarak randomize edildi. Hastaların preoperative (preop), postoperative (po) 3. ve 7. gün ve stent çekildikten 1 hafta sonraki ağrı ve diğer şikayetleri kaydedildi. Hastaların ağrı düzeyleri Sayısal Ağrı Skalası(SAS) kullanılarak belirlendi.

Bulgular: 40 yaş altı Grup 1’de (4.8 fr) preop SAS skoru 9,17±0,2 iken, Grup 2’de (6 fr) 9,79±0,15 (p=0,099) saptandı. Bu gruplarda po 3. gün SAS skoru sırasıyla 2,50±0,73, 7,36±0,45 (p<0.05), po 7. gün sırasıyla 1,92±0,53, 2,57±0,48 (p=0,428) saptandı. DJ katater çekildikten 1 hafta sonra SAS skorları sırasıyla 0,08±0,08, 0,57±0,23 (p=0,087) idi. 40 yaş üstü her iki grupta da belirtilen zamanlarda bakılan SAS skorları arasında anlamlı bir fark bulunamadı. Ortalama taş boyutu ve operasyon süreleri açısından gruplar arasında anlamlı bir fark saptanmadı.

Sonuç: Özellikle 40 yaş altı genç hastalarda endoskopik üreter taş tedavisinde 4.8 Fr DJ katater kullanımının hastanın po erken dönemdeki ağrı kontrolü için daha etkili olduğu bulunmuştur. Ayrıca üreteral stentlerin kullanılmasının gerekliliği ve optimal stentlerin hangi özelliklere sahip olması gerektiği ile ilgili daha fazla çalışmaya ihtiyaç duyulmaktadır.

Keywords

üreter stenti, üreter taşı, üreterorenoskopi

The Effect of Ureteral Stents on Postoperative Pain

Abstract

Aim: We aimed to assess the postoperative pain after endoscopic ureter stone treatment according to the diameter of double J ureteral stents.

Materials and Methods: Our prospective randomized study included 63 patients with successful operation for unilateral ureter stone and DJ ureteral stent inserted. Patients were divided into 2 subgroups as aged under 40 years and over 40 years. These subgroups were randomized into 4.8 Fr and 6 Fr ureteral DJ stent groups preoperatively in double-blind manner. Patients had pain and other complaints recorded preoperative (preop), postoperative (po) 3rd, 7th days and 1 week after stent removal. Patient pain levels were determined using the numerical pain scale (NPS).

Results: For patients under 40 years of age, Group 1 had preop NPS score of 9.17±0.32, while in Group 2 this was 9.79±0.15 (p=0.099), on po 3rd day NPS scores were 2.50±0.73 and 7.36±0.45 (p<0.05), on po 7th day scores were 1.92±0.53 and 2.57±0.48 (p=0.428), and 1 week after DJ catheter removal scores were 0.08±0.08, 0.57±0.23 (p=0.087), respectively. In both groups over 40 years of age, there were no significant differences in the NPS scores at these times. There were no significant differences identified between the groups for stone size and operation duration.

Conclusions: We think the use of 4.8 Fr DJ catheters after endoscopic ureter stone treatment is more appropriate for pain control in the early po period, especially for young patients under 40 years of age. Additionally, we believe there is a need for more studies related to the necessity for use of ureteral stents and the features that optimal stents should have.

Keywords

ureteral stent, ureter stone, ureterorenoscopy

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