Mp26-05 Effect of Antihistamine on Ureteral Stent-Related Symptoms: A Double-Blind Randomized Controlled Trial

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (MP26)1 May 2024MP26-05 EFFECT OF ANTIHISTAMINE ON URETERAL STENT-RELATED SYMPTOMS: A DOUBLE-BLIND RANDOMIZED CONTROLLED TRIAL David S. Han, Ezra J. Margolin, Miyad Movassaghi, Jeffrey P. Johnson, Mahveesh Chowdhury, Srinath-Reddi Pingle, Ron Golon, Michael L. Schulster, David M. Weiner, and Ojas Shah David S. HanDavid S. Han , Ezra J. MargolinEzra J. Margolin , Miyad MovassaghiMiyad Movassaghi , Jeffrey P. JohnsonJeffrey P. Johnson , Mahveesh ChowdhuryMahveesh Chowdhury , Srinath-Reddi PingleSrinath-Reddi Pingle , Ron GolonRon Golon , Michael L. SchulsterMichael L. Schulster , David M. WeinerDavid M. Weiner , and Ojas ShahOjas Shah View All Author Informationhttps://doi.org/10.1097/01.JU.0001009408.66023.77.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Histamine is a mast cell-derived mediator shown to be involved in ureteral peristalsis as well as bladder contraction, inflammation, and hypersensitivity. Given the efficacy of antihistamines for symptom relief in bladder pain syndrome by potentially blocking mast cell activation, we evaluated the effect of antihistamine medication on ureteral stent-related symptoms. METHODS: We performed a double-blind randomized controlled trial of adults undergoing unilateral primary ureteroscopy with stent placement for kidney/ureteral stone treatment. Coloplast Imajin® silicone stents (Coloplast A/S, Humlebaek, Denmark) were used for all procedures. In addition to non-steroidal anti-inflammatory medications for post-operative pain control, patients were randomly prescribed a 10-day course of either fexofenadine 180mg oral daily (study arm) or placebo (control arm). Patients were prescribed breakthrough narcotic analgesia only as needed. Patients completed the Ureteral Stent Symptom Questionnaire (USSQ) three times: pre-operatively without stent, with stent in situ immediately prior to stent removal, and post-stent at 4- to 6-week follow-up. Higher scores represented increasing symptom severity. The primary outcomes were differences in USSQ urinary symptoms and pain scores immediately prior to stent removal, compared using Student's t-test. RESULTS: Of 76 patients (37 control arm and 39 study arm), mean age was 53 years and majority were men (59%). Mean stone burden (10 mm) and time to stent removal (11 days) were similar between groups. With stent in situ, there were no differences in urinary symptoms or pain scores between study and control groups (29 vs. 28, p=0.92 and 14 vs. 16, p=0.41; Figure 1); moreover, there were no differences between arms in any USSQ domain (p>0.05). There were no differences between study and control groups in mean duration of narcotic analgesia use (0.05 vs. 0.13 day, p=0.21), mean number of office phone calls for urinary symptoms (0.15 vs. 0.24, p=0.45), or absolute number of Emergency Department visits in each cohort (3 vs. 3, p=1.00). No patient experienced adverse drug events (e.g., urinary retention) or post-operative complications. CONCLUSIONS: Post-operative antihistamines were well-tolerated but did not significantly reduce ureteral stent-related symptoms. Download PPT Source of Funding: Coloplast – investigator-initiated trial © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e415 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information David S. Han More articles by this author Ezra J. Margolin More articles by this author Miyad Movassaghi More articles by this author Jeffrey P. Johnson More articles by this author Mahveesh Chowdhury More articles by this author Srinath-Reddi Pingle More articles by this author Ron Golon More articles by this author Michael L. Schulster More articles by this author David M. Weiner More articles by this author Ojas Shah More articles by this author Expand All Advertisement PDF downloadLoading ...