Balneoterapinin (Kaplıca Tedavisi) JJ Stentlerle İlişkili Alt Üriner Sistem Semptomları Üzerindeki Etkisinin Değerlendirilmesi: Prospektif Plasebo Kontrollü Bir Çalışma

Yıl 2024, Cilt: 16 Sayı: 3, 91 - 98, 29.09.2024

İsmail Emre Ergin , Adem Sancı , Abuzer Öztürk , Aydemir Asdemir , Hüseyin Saygın

https://doi.org/10.54233/endourolbull-1517384

Öz

Amaç
Üreter taş tedavisi sonrası yerleştirilen JJ Stent ilişkili Alt üriner sistem semptomları hastaların operasyon sonrası en çok şikayet ettiği konular arasındadır. Bu semptomları azaltmak için bir çok tedavi metodu denenmiştir. Balneoterapinin (spa tedavisi) JJ stentleriyle ilişkili alt üriner sistem semptomları üzerindeki etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntemler
Tek taraflı üreter taş tedavisi yapılan ve üreteral JJ stent yerleştirilen hastalar operasyon sonrası Kontrol, Tolterodin ve Balneoterapi grupları olmak üzere 3 gruba ayrıldılar. Post op 1. Hafta ve 4. Hafta Üreteral Stent Semptom Skorları ölçüldü. Analjezik tablet kullanım miktarları kaydedildi.
Bulgular
4. Hafta gruplar birbileri ile kıyaslandığında Tolterodin ve Balneoterapi gruplarının Analjezik kullanımı, Üriner semptomları, Vücut Ağrı skorları kontrol grubuna göre daha düşük tespit edildi (p< .001). Gruplar kendi içlerinde 1. ve 4. Hafta kıyaslandığında kontrol grubunda bir değişiklik yokken diğer gruplarda anlamlı değişiklik mevcuttu.
Sonuç
Bölge halkının davranışlarından esinlendiğimiz bu yazımızda Balneoterapinin tedavisiz gruba göre anlamlı semptom iyileşmesi sağlaması ve diğer medikasyonlar kadar iyi sonuçlar vermesi bundan sonraki süreçlerde hastalara önerilebilecek kolay, düşük maliyetli, düşük yan etkili bir tedavi metodu gibi görülmektedir.

Anahtar Kelimeler

Balneoterapi, Üreter kateterizasyon, Taş cerrahisi

Destekleyen Kurum

Yok

Evaluation of the Effect of Balneotherapy (Spa Treatment) on Lower Urinary Tract Symptoms Associated with JJ Stents: A prospective placebo-controlled study

Öz

Objective:
Lower urinary tract symptoms related to the JJ Stent placed after ureteral stone treatment are among the issues that patients complain about the most after the operation. We aimed to assess the impact of balneotherapy (spa treatment) on lower urinary tract symptoms associated with JJ stents.
Material and Methods:
Patients who underwent unilateral ureteral stone treatment and ureteral JJ stent placement were divided into 3 groups after the operation: Control, Tolterodin and Balneotherapy (spa treatment) groups. Post-op 1st week and 4th week ureteral stent symptom scores were measured. Analgesic tablet usage amounts were recorded.
Results:
When the groups were compared to each other in the 4th week, Analgesic using, Urinary symptoms, Body pain scores of Tolterodin and Balneotherapy groups were found to be lower than the control group (p < .001). When the groups were compared between the 1st and 4th weeks, there was no change in the control group, but there was a significant change in the other groups.
Conclusions:
In this article, inspired by the behavior of the local people, we see that Balneotherapy provides significant symptom improvement compared to the non-treatment group and gives as good results as other medications, as an easy, low-cost, low-side-effect treatment method that can be recommended to patients in the future.

Anahtar Kelimeler

Balneotherapy, Ureteral catheterization, Lithotripsy

Kaynakça

• 1. Zimskind PD, Fetter TR, Wilkerson JL (1967) Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol 97:840-844. https://doi.org/10.1016/s0022-5347(17)63130-6
• 2. Joshi HB, Okeke A, Newns N (2002) Characterization of urinary symptoms in patients with ureteral stents. Urology 59: 511-519. https://doi.org/10.1016/s0090-4295(01)01644-2
• 3. Hao P, Li W, Song C (2008) Clinical evaluation of double- pigtail in patients with upper urinary tract diseases: Report of 2685 cases. J Endourol 22:65-70. https://doi.org/10.1089/end.2007.0114
• 4. Joshi HB, Stainthorpe A, Macdonagh RP, Keeley FX Jr, Timoney AG, Barry MJ (2003) Indwelling ureteral stents: Evaluation of symptoms, quality of life and utility. J Urol 169:1065-1069. https://doi.org/10.1097/01. ju.0000048980.33855.90
• 5. Krambeck AE, Walsh RS, Denstedt JD, Preminger GM, Li J, et al (2010) A novel drug eluting ureteral stent: aprospective, randomized, multicenter clinical trial to evaluate the safety and effectiveness of a ketorolac loaded ureteral stent. J Urol 183(3):1037-1042. https://doi.org/10.1016/j.juro.2009.11.035
• 6. Park SC, Jung SW, Lee JW, Rim JS (2009) The effects of tolterodine extended release and alfuzosin for the treatment of double-j stent-related symptoms. J Endourol 23:1913-7. https://doi.org/10.1089/end.2009.0173
• 7. Cinar O, Tanidir Y, Ozer S, Çizmeci S, Erbatu O, et al (2021) Effects of mirabegron on JJ stent-related symptoms: A multicentric study. Int J Clin Pract 75(2):e13857. https://doi.org/10.1111/ijcp.13857
• 8. Bender T, Bálint G, Prohászka Z, Géher P, Tefner IK (2014) Evidence-based hydro- and balneotherapy in Hungary--a systematic review and meta-analysis. Int J Biometeorol. 58(3):311-323. https://doi.org/10.1007/s00484-013-0667-6
• 9. Gutenbrunner C, Bender T, Cantista P, Karagülle Z. (2010). A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. International Journal of Biometeorology, 2020;54,:495-507. https://doi.org/10.1007/s00484-010-0321-5
• 10. Kamioka H, Tsutani K, Okuizumi H, Mutoh Y, Ohta M, et al (2010). Effectiveness of aquatic exercise and balneotherapy: a summary of systematic reviews based on randomized controlled trials of water immersion therapies. Journal of epidemiology, 20(1), 2-12. https://doi.org/10.2188/jea.JE20090030
• 11. Joshi HB, Newns N, Stainthorpe A, Mac-Donagh RP, Keeley FX Jr, et al (2003) Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol 169:1060. https://doi.org/10.1097/01.ju.0000049198.53424.1d
• 12. Tanidir Y, Mangir N, Sahan A, Sulukaya M (2017) Turkish version of the ureteral stent symptoms questionnaire: linguistic and psychometric validation. World J Urol 35:1149-1154. https://doi.org/10.1007/s00345-016-1958-4
• 13. Calvert RC, Wong KY, Chitale SV, et al (29013) Multi-length or 24 cm ureteric stent? A multicentre randomised comparison of stent-related symptoms using a validated questionnaire. BJU Int 111:1099-1104. https://doi.org/10.1111/j.1464-410x.2012.11388.x
• 14. Sameh WM, Eid AA (2012) Pressure transmission through ureteric stents: a novel in vivo human study. Urology 79(4):766-770. https://doi.org/10.1016/j.urology.2011.10.056
• 15. Siggers JH, Waters S, Wattis J, Cummings L (2009)Flow dynamics in a stented ureter. Math Med Biol 26(1):1-24. https://doi.org/10.1093/imammb/dqn020
• 16. Yavuz A, Kilinc MF, Aydin M, Ofluoglu Y, Bayar G (2021) Does tamsulosin or mirabegron improve ureteral stentrelated symptoms? A prospective placebo-controlled study. Low Urin Tract Symptoms 13(1):17-21. https://doi.org/10.1111/luts.12320
• 17. Lim KT, Kim YT, Lee TY, Park SY (2011) Effects of tamsulosin, solifenacin, and combination therapy for the treatment of ureteral stent related discomforts. Korean J Urol Jul;52(7):485-488 https://doi.org/10.4111/kju.2011.52.7.485
• 18. EAU Guidelines (2023) on Management of Non-neurogenic Male LUTS/ Muscarinic receptor antagonists (internet) https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts/chapter/disease-management
• 19. Pöyhönen A, Åkerla J, Koskimäki J, Tammela TLJ, Auvinen A (2022) Sauna habits/bathing and changes in lower urinary tract symptoms - Tampere Ageing Male Urologic Study (TAMUS). Scand J Urol 56(1):77-82. https://doi.org/10.1080/21681805.2021.2002403
• 20. Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence. Mayo Clin. Proc. 2018;93:1111–21.