Investigating the Effect of Lettuce Extract Compared to Placebo on Urinary Symptoms Caused by Placing a Double-J Stent in the Ureter Following Ureteroscopy and Transurethral Lithotripsy in Men with Ureteral Stones

Authors

DOI:

https://doi.org/10.22100/jkh.v19i1.3212

Keywords:

Transurethral lithotripsy, Lettuce, , Double J stent, Ureteral stone

Abstract

Introduction: The ureteral stent is one of the most useful devices in urology to remove obstructions that can cause problems for the patient. This study was conducted to determine the effects of lettuce on improving symptoms caused by stents.

Methods: The clinical trial included 60 male participants with ureteral stones who were treated with ureteroscopy and stone fragmentation through the urethra. Urinary symptoms were evaluated using the USSQ questionnaire initially and again two weeks after the intervention. The participants were divided into two groups: the intervention group, which received tamsulosin and lettuce extract, and the control group, which received tamsulosin and a placebo. Statistical analysis was performed using SPSS software, utilizing appropriate statistical tests with a significance level set at 0.05.

Results: The average age of the patients studied was 44.6±14.5 years. For the control group, the initial mean score for urinary symptoms was 26.64±3.13, which decreased to 16.58±2.84 two weeks after the intervention. In the intervention group, the initial score was 28.27±5.05, reducing to 15.68±2.42 post-intervention. There was a statistically significant difference noted within each group (P=0.001). However, between the two groups, no statistically significant difference was observed either before (P=0.136) or after the intervention (P=0.198).

Conclusion: In the comparison of the two groups, lettuce did not demonstrate a significant effect on reducing urinary symptoms in the study subjects after the intervention. This issue can be due to the small sample size, the short duration of the study, the underlying disease of the patients and the type of lettuce planted. Future studies with longer duration are recommended.

References

Soria F, Morcillo E, Lopez de Alda A, Pastor T, Sanchez-Margallo F. Biodegradable catheters and urinary stents. When? Archivos Espanoles de Urologia. 2016;69(8):553-64. PMID: 27725331

Todd AM, Knudsen BE. Ureteral stent materials: past, present, and future. Ureteric Stenting. 2017:83-90. https://doi.org/10.1002/9781119085713.ch9

Kanematsu H, Kudara H, Kanesaki S, Kogo T, Ikegai H, Ogawa A, et al. Application of a loop-type laboratory biofilm reactor to the evaluation of biofilm for some metallic materials and polymers such as urinary stents and catheters. Materials. 2016;9(10):824. https://doi.org/10.3390/ma9100824

Buchholz N, Hakenberg O, Masood J, Bach C. Handbook of urinary stents: basic science and clinical applications: JP Medical Ltd; 2016.

Maldonado-Avila M, Garduño-Arteaga L, Jungfermann-Guzman R, Manzanilla-Garcia HA, Rosas-Nava E, Procuna-Hernandez N, et al. Efficacy of Tamsulosin, Oxybutynin, and their combination in the control of double-j stent-related lower urinary tract symptoms. International braz j urol. 2016;42:487-93. https://doi.org/10.1590/S1677-5538.IBJU.2015.0186

Méndez-Probst CE, Razvi H, Denstedt JD. Fundamentals of instrumentation and urinary tract drainage. Campbell-Walsh Urology 10th Ed Philadelphia: Elsevier Saunders. 2012:177-90.

Miyaoka R, Monga M. Ureteral stent discomfort: Etiology and management. Indian journal of urology: IJU: journal of the Urological Society of India. 2009;25(4):455.https:// DOI: 10.4103/0970-1591.57910

Joshi H, Stainthorpe A, MacDonagh R, Keeley F, Timoney A. Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. The Journal of urology. 2003;169(3):1065-9. https://doi.org/10.1097/01.ju.0000048980.33855.90

Keeley Jr FX, Timoney AG. Routine stenting after ureteroscopy: think again. Citeseer; 2007. p. 642-4.https:// DOI: 10.1016/j.eururo.2007.01.042

Haleblian G, Kijvikai K, de la Rosette J, Preminger G. Ureteral stenting and urinary stone management: a systematic review. The Journal of urology. 2008;179(2):424-30. https://doi.org/10.1016/j.juro.2007.09.026

Joshi H, Newns N, Stainthorpe A, MacDonagh R, Keeley F, Timoney A. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. The Journal of urology. 2003;169(3):1060-4. https://doi.org/10.1097/01.ju.0000049198.53424.1d

Dellis A, Joshi HB, Timoney AG, Keeley Jr FX. Relief of stent related symptoms: review of engineering and pharmacological solutions. The Journal of urology. 2010;184(4):1267-72. https://doi.org/10.1016/j.juro.2010.06.043

Dellis AE, Keeley Jr FX, Manolas V, Skolarikos AA. Role of α-blockers in the treatment of stent-related symptoms: a prospective randomized control study. Urology. 2014;83(1):56-62. https://doi.org/10.1016/j.urology.2013.08.067

Park HK, Paick SH, Kim HG, Lho YS, Bae S. The impact of ureteral stent type on patient symptoms as determined by the ureteral stent symptom questionnaire: a prospective, randomized, controlled study. Journal of endourology. 2015;29(3):367-71. https://doi.org/10.1089/end.2014.0294

Jabbari A, Farshi A, Bazargani HS, Hajebrahimi S. Validity and reliability of the ureteral stent symptoms questionnaire to Persian language. Journal of Research in Clinical Medicine. 2014;3(1):17-22.http:// doi: 10.5681/jarcm.2015.003

Gupta M, Patel T, Xavier K, Maruffo F, Lehman D, Walsh R, et al. Prospective randomized evaluation of periureteral botulinum toxin type A injection for ureteral stent pain reduction. The Journal of urology. 2010;183(2):598-602. https://doi.org/10.1016/j.juro.2009.10.021

Navanimitkul N, Lojanapiwat B. Efficacy of tamsulosin 0.4 mg/day in relieving double-J stent-related symptoms: a randomized controlled study. Journal of International Medical Research. 2010;38(4):1436-41. https://doi.org/10.1177/147323001003800425

Shalaby E, Ahmed A-f, Maarouf A, Yahia I, Ali M, Ghobish A. Randomized controlled trial to compare the safety and efficacy of tamsulosin, solifenacin, and combination of both in treatment of double-j stent-related lower urinary symptoms. Advances in urology. 2013;2013. https://doi.org/10.1155/2013/752382

Kuyumcuoglu U, Eryildirim B, Tuncer M, Faydaci G, Tarhan F, Ozgül A. Effectiveness of medical treatment in overcoming the ureteral double-J stent related symptoms. Canadian Urological Association Journal. 2012;6(6):E234.http://doi: 10.5489/cuaj.10143.

Nazim SM, Ather MH. Alpha-blockers impact stent-related symptoms: a randomized, double-blind, placebo-controlled trial. Journal of endourology. 2012;26(9):1237-41. https://doi.org/10.1089/end.2012.0036

Tehranchi A, Rezaei Y, Khalkhali H, Rezaei M. Effects of terazosin and tolterodine on ureteral stent related symptoms: a double-blind placebo-controlled randomized clinical trial. International braz j urol. 2013;39:832-40. https://doi.org/10.1590/S1677-5538.IBJU.2013.06.09

Park HK, Choi EY, Jeong BC, Kim HH, Kim BK. Localizations and expressions of α-1A, α-1B and α-1D adrenoceptors in human ureter. Urological research. 2007;35:325-9. https://doi.org/10.1007/s00240-007-0118-0

Yakoubi R, Lemdani M, Monga M, Villers A, Koenig P. Is there a role for α-blockers in ureteral stent related symptoms? A systematic review and meta-analysis. The Journal of urology. 2011;186(3):928-34. https://doi.org/10.1016/j.juro.2011.04.061

Zhou L, Cai X, Li H, Wang K-j. Effects of α-blockers, antimuscarinics, or combination therapy in relieving ureteral stent-related symptoms: a meta-analysis. Journal of Endourology. 2015;29(6):650-6. https://doi.org/10.1089/end.2014.0715

Bent S. Herbal medicine in the United States: review of efficacy, safety, and regulation: grand rounds at University of California, San Francisco Medical Center. Journal of general internal medicine. 2008;23:854-9. https://doi.org/10.1007/s11606-008-0632-y

Zargari A. Iranian medicinal plants. Tehran: Tehran University Publications. 1997;136.

Bishehsari F. Practice of sense and nonsense in the medicine, readers' views. Archives of Iranian medicine. 2014;17(6):461-3. PMID: 25039090

Bahmani M, Baharvand-Ahmadi B, Tajeddini P, Rafieian-Kopaei M, Naghdi N. Identification of medicinal plants for the treatment of kidney and urinary stones. Journal of renal injury prevention. 2016;5(3):129. http://doi: 10.15171/jrip.2016.27

Modaresi M, Tavanaei F. The Effect of Hydro-Alcoholic Extracts of Lettuce (Lactuca sativa) on Spermatogenesis and Sexual Hormones in Male Mice. Journal of Zanjan University of Medical Sciences & Health Services. 2013;21(87).

Tookoli Tabasi K MS, Barkati N. Investigating the effect of prescribing prazosin and oxybutynin on the severity of symptoms caused by the insertion of a double J stent in patients undergoing transurethral lithotripsy (TUL). Alborz University Medical Journal. 2013;3(1):1-6.

Ghari A, Amini M, Kamali A, Alizadeh S, Latifi SA. Effectiveness of Lettuce Syrup in Relieving Pain After Inguinal Hernia Surgery: A Clinical Trial. Complementary Medicine Journal. 2022;12(3):294-303.https://doi: 10.32598/cmja.12.3.614.3

Jafari H, Latifi SA, Bayani M. Evaluation of the effectiveness of Lactuca Sativa syrup in controlling pain after periodontal flap surgery: a split-mouth, randomized, double-blind placebo-controlled trial. Journal of Complementary and Integrative Medicine. 2022. https://doi.org/10.1515/jcim-2021-0190

Sayyah M, Hadidi N, Kamalinejad M. Analgesic and anti-inflammatory activity of Lactuca sativa seed extract in rats. Journal of Ethnopharmacology. 2004;92(2-3):325-9. https://doi.org/10.1016/j.jep.2004.03.016

Dehbooreh R, Heshmatian Z, Ashrafi Babaganjeh L, Khadem Ansary MH, Ashrafi L, Bahramy Azar P, et al. Study of the Effect of Hydro-Alcoholic Extract of Lactuca sativa on Arterial Blood Pressure and Heart Rate in Rats. Avicenna Journal of Clinical Medicine. 2013;20(1):66-76.

Khanna A, Monga M, Sun D, Gao T, Schold J, Abouassaly R. Ureteral stent placement during shockwave lithotripsy: characterizing guideline discordant practice. Urology. 2019;133:67-71. https://doi.org/10.1016/j.urology.2019.06.015

Self D. Ureteral stent causing urinary incontinence: An unusual suspect. Urology Case Reports. 2018;21:50. https://doi.org/10.1016/j.eucr.2018.08.022

Published

2024-05-15

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Original Article(s)

How to Cite

Investigating the Effect of Lettuce Extract Compared to Placebo on Urinary Symptoms Caused by Placing a Double-J Stent in the Ureter Following Ureteroscopy and Transurethral Lithotripsy in Men with Ureteral Stones. (2024). Knowledge and Health in Basic Medical Sciences, 19(1), Page: 47-56. https://doi.org/10.22100/jkh.v19i1.3212

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