Mp26-06 Treatment of Ureteral Stent-Related Symptoms With a Transcutaneous Electrical Nerve Stimulator

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (MP26)1 May 2024MP26-06 TREATMENT OF URETERAL STENT-RELATED SYMPTOMS WITH A TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR Rohit Tejwani, Shaun Hager, Ryan Sun, Nishant Doctor, Sneha Mohile, Timothy Chang, and Simon Conti Rohit TejwaniRohit Tejwani , Shaun HagerShaun Hager , Ryan SunRyan Sun , Nishant DoctorNishant Doctor , Sneha MohileSneha Mohile , Timothy ChangTimothy Chang , and Simon ContiSimon Conti View All Author Informationhttps://doi.org/10.1097/01.JU.0001009408.66023.77.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral stent placement following ureteroscopy (URS) is prevalent despite current controversies. Nonpharmacologic methods to manage stent-related symptoms are needed in light of efforts to reduce opiate prescription and lack of efficacy of current regimens. Transcutaneous electrical nerve stimulation (TENS) therapy is an effective and safe form of patient-controlled analgesia for a range of conditions and a 2006 randomized trial suggested efficacy in reducing renal colic in the pre-hospital setting. We sought to evaluate the use of TENS for stent-related symptoms in patients undergoing URS for urolithiasis. METHODS: Participants undergoing unilateral URS with lithotripsy at a tertiary center were randomized to receive standard therapy consisting of multiagent pharmacotherapy (NSAID, acetaminophen, alpha blocker, and opioids if pain still not controlled) versus standard therapy with adjunctive TENS at home using an FDA-approved device. Daily symptom scores via 10-point scale assessments of common domains were completed through 2 days post-stent removal. The validated Ureteral Stent Symptom Questionnaire (USSQ) and open-ended experiential questions (EQ) were administered at the first postoperative visit. Mean daily and USSQ scores per domain were compared via two-tailed t-tests and descriptive statistics as appropriate. Experiential comments were qualitatively analyzed by thematic coding. RESULTS: A total of 28 patients participated with 17 randomized to receive TENS. Average age was 52.9 vs. 63.1 y. Differences in average abdominal pain scores (3.52±3.08 vs. 3.42±2.85; p=0.929), groin pain (4.33±2.59 vs. 4.02±2.44; p=0.758), pain frequency (4.70±2.33 vs. 5.22±2.28; p=0.564) or nausea intensity (1.18±1.63 vs. 1.98±2.01; p=0.259) did not vary significantly between groups. 23 patients completed the USSQ with no difference in total (30.23±6.48 vs. 29.3±11.02, p=0.802) nor sub-domain scores. 13 TENS patients completed the EQ; 12 (92.3%) noted positive experiences with 10 (76.9%) preferring TENS to medication partially or entirely and 9 (69.2%) attributing TENS to decreased pain symptoms. None reported decreased nausea or urinary symptoms. CONCLUSIONS: While patients who received a TENS device reported subjective improvement of their symptoms and decreased pain medication use, these differences were not evident when compared to a control group. There remains strong interest by patients in non-pharmacologic symptom management options, but in our study the use of a TENS device does not seem to decrease symptom scores and pain medication use. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e416 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Rohit Tejwani More articles by this author Shaun Hager More articles by this author Ryan Sun More articles by this author Nishant Doctor More articles by this author Sneha Mohile More articles by this author Timothy Chang More articles by this author Simon Conti More articles by this author Expand All Advertisement PDF downloadLoading ...