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• W2783274497 abstract "INTRODUCTION:By definition, the double-J or pigtail stent is a tube placed within the ureterallumen in a retrograde or antegrade fashion in order to maintain its patency. Thedouble-J ureteral stent had been widely applied during the endourologic surgery torelieve or prevent ureteral obstruction. Stent-related morbidities, such as lowerurinary tract symptoms (LUTS), stent-related body pain and hematuria, arebothersome and might have a negative impact on quality of life (QoL) and sexualperformance for both genders. Stent discomfort can vary from one patient toanother in an idiosyncratic manner, but is believed to affect over 80% of patients.The prevalence hence is significant and geographic4variance might exist. Thismakes this issue an important health problem and indirectly serves as a scale forquality of healthcare delivery to the public. The pathophysiology of stent-relatedsymptoms remains unclear. However, the pain and LUTS caused by stentplacement has been attributed lower ureter and bladder spasm due to local irritationof the stent. Studies utilizing pharmaco therapeutic agents like Tamsulosin andother antimuscarinics and blockers were shown to improve symptoms but thebenefit is obtained by preventing unwarranted bladder5contractility or otherunknown mechanism (in case ofblockers) . In all these studies the primaryproblem is not addressed and remains unknown. Patients who fail to respond tosuch pharmacotherapy are left with limited options or else removal of the stent(irrespective of the consequence). Also, attempt to modify the design of bladderend of the stent was studied (James E. Lingeman et. al). The results showed nosignificant difference among the groups. A complete understanding of thepathogenesis of stent-related symptoms is limited by the lack of systematicanalysis of the same. The role of micro-organisms (pathogenic/opportunistic) inthis scenario is less investigated and reported.AIM :To compare the microbial culture of DJ stents to that of symptomatology, inpatients having lower urinary tract symptoms after DJ stenting.MATERIALS AND METHODS:Patients who were admitted in Kilpauk Medical College and Govt. RoyapettahHospital and undergone DJ stenting following which they developedsignificant lower urinary tract symptoms were included in the study. 45 patientswere followed up prospectively and were observed and assessed for severity ofstent related lower urinary tract symptoms using IPSS questionnaire.Vesical endof DJ stent was subjected to microbial culture and sensitivity. The result ofmicrobial culture positivity of DJ stent was correlated to IPSS score, status ofurine microbial culture, the relevance to timing of stent removal and otherparametersRESULTS:The mean age of the study group was30.71 years. 28 were males and 17 werefemales.16 patients had stent on the right side and 25 had on the left side. 4patients had bilateral stenting. The mean IPSS score was 20.25. Dysuria waspredominant in 66.4%, frequency in 22.7% and urgency in 7.2 %. Femalepatients had more incidences of severe IPSS. Moderate IPSS (8-19) notedpredominantly in 26-30 years.in the group 31-35 years it was predominantlysevere (IPSS 20-35).62.2% gave Quality of Life score of 4. 15.5% had a scoreof 5. 8 patients gave the score as 3 and 2 patients gave a score 6. Adjusted tobilaterality, DJ stent culture was most commonly E.coli followed bykelbsiella,pseudomonas,enterococcus. The same pattern of hierarchy noted inurine culture. When analysed with SPSS v2 software, age and sex were notsignificant determinant of positive stent culture, nor they predicted severe IPSSscore. IPSS score correlated positively with DJ stent culture. Statisticalsignificance was seen when IPSS was tested against combine positivity of DJand urine culture (P value 0.001). Urine culture in predicting positive stentculture had 48.3% accuracy. Stent removal was early in patients with severeIPSS and was statistically significant when correlated to combined microbialpositive culture (P value 0.003)CONCLUSION:Stent related symptoms are a significant problem and the prevalence iscommon. Age and sex of the patient does not predict severity of stent relatedsymptoms nor they are linked to positive stent culture. The quality of life basedon IPSS questionnaire shows that majority of the patients are unhappy with thebothersome nature of stent related symptoms. Early stent removal wasstatistically associated with positive microbial culture (DJ stent, urine andcombined) and severity of IPSS. Urine culture is not a strongly predictivevariable for positive DJ stent culture." @default.
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• W2783274497 date "2014-08-01" @default.
• W2783274497 modified "2023-09-27" @default.
• W2783274497 title "A study on correlation of microbial culture of stent and symptomatology in patients with lower urinary tract symptoms (LUTS) after DJ stenting." @default.
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