• Regina D Norris, Roger L Sur, W Patrick Springhart, Charles G Marguet, Barbara J Mathias, Paul K Pietrow, David M Albala, and Glenn M Preminger.
• Division of Urology, Duke University Medical Center, Durham, North Carolina 27710, USA.
• Urology. 2008 May 1; 71 (5): 792-5.

ObjectivesUreteral stents commonly cause lower urinary tract and flank discomfort. We evaluated the use of extended release oxybutynin versus phenazopyridine versus placebo for the management of ureteral stent discomfort after ureteroscopy.MethodsEach of 60 patients who received a unilateral stent after ureteroscopy was given a blister pack containing 21 unmarked capsules of either extended release oxybutynin 10 mg, phenazopyridine 200 mg, or placebo in a prospective, randomized, and double-blinded fashion. Patients were instructed to take 1 capsule 3 times daily immediately after the procedure. Patients were given 50 tablets of oral narcotic to be taken as needed. Patients reported bothersome scores for flank pain, suprapubic pain, urinary frequency, urgency, dysuria, and hematuria on postoperative day 1, day 2, and the day of stent removal. Narcotic use was also recorded.ResultsEight patients were excluded from the analysis for stent migration necessitating early removal (1), uncontrollable pain (1), failure to complete blister pack (4), and inability to contact for follow-up surveys (2). There was no difference in bothersome score among the groups for flank pain, suprapubic pain, urinary frequency, urgency, and dysuria. The phenazopyridine group reported less hematuria on postoperative day 1 when compared with placebo, which was statistically significant. The oxybutynin group required fewer narcotics, but this finding was not statistically significant.ConclusionsAlthough this study failed to show a significant difference in bothersome scores among the groups, the small sample size precludes definitive conclusion. Future studies pooling these data will determine the overall treatment effect and the optimal management of ureteral stent morbidity.

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