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E9 Music as analgesia during ESWL a randomized clinical trial
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THURSDAY 10 SEPTEMBER 2015 / EUROPEAN UROLOGY SUPPLEMENTS 14 (2015) 29–78
E8 Comparison of the pain and anxiety scores between the first and second session SWL treatment for kidney stone patients Yilmaz Ö., Saraçoğlu F., Yeşildal C., Soydan H., Ateş F., Zor M., Şenkul T. Gata Haydarpasa Training Hospital, Dept. of Urology, Istanbul, Turkey Introduction and objectives: SWL plays a major role in the minimal invasive treatment of urinary stone disease, with adding a significant anxiety and pain. Moreover, sometimes these disadvantages may prevent an effectively performed SWL session. In this study we evaluated whether or not the anxiety and pain scores will be different between the first and second session SWL treatment. Materials and methods: Between March 2014 and January 2015, a total of 126 patients who underwent SWL treatment due to a 1-2 cm kidney stone included to the study. Patient anxiety and pain were evaluated with “hospital anxiety and depression scale (HADS)” and “visual analog score (VAS)” prior and during the therapy, respectively. Age, sex, body mass index (BMI), stone burden, applied energy and SW numbers were recorded. Results: First time SWL performed patients were conducted in group 1 and second time SWL performed patients in group2. There were 70 patients (56 male and 14 female) in group 1 and 56 patients (47 male and 9 female) in group 2. Age, sex, BMI and stone burden were similar between the two groups. While VAS scores were significantly lower (5,23±2,94 vs 6,41±2,37) in the second group, HADS scores were higher without statistical significance (6,39±3,49 vs 5,44±3,81) (Table 1). Table 1
Age BMI Stone burden Sex M F HASD score VAS score
1. session SWL
2.session SWL
p
42,34±15,07 26,18±4,17 10,14±4,37 n: 56 %80 n: 14 %20 5,44±3,81 6,41±2,37
43,23±15,08 26,63±4,34 8,86±4,25 n: 47 %83.90 n: 9 %16.10 6,39±3,49 5,23±2,94
0,550 0,750 0,099 0.570 0,091 0,030*
*p<0.05: Statistical significance
Conclusions: First timers of SWL treatment experience higher pain and this probably leads higher anxiety in the second session. Better pain control during the first session will probably lead successfully completed first sessions and a consistence to continue the future treatment sessions. E9 Music as analgesia during ESWL a randomized clinical trial Betancourt Hernández J., Budia Alba A., Trassierra Villa M., Bahílo P., López-Acón J.D., Álvarez A., Boronat Tormo F. Hospital Universitari i Politècnic La Fe, Dept. of Urology, Valencia, Spain Introduction and objectives: To establish if music decreases pain during a session of extracorporeal shock wave lithotripsy (ESWL) and improves the satisfaction rate. Materials and methods: Simple randomization controlled clinical trial, including patients with ureteral or kidney stones attending the first session of ESWL from September 2014 to December 2014. Two groups, one received standard analgesia and headphones choosing between 5 different types of music played during the entire session, the other received standard analgesia only. The variables recorded were age, gender, two questionnaires before and after ESWL with two pain questions (Likert scale of 0-10 (A1a) and visual analogue scale (A1b) as cross-check) and a third on anxiety (Likert (A2) 0-10). Also heart
rate (HR), respiratory rate (RR), blood pressure (systolic (SBP), diastolic (DBP), interruption of procedure, total dolantine (mg), secondary analgesia, intensity (Hz). The questionnaires were administered before and after ESWL with an extra post-ESWL question about treatment satisfaction (Likert scale of 0-10 (A3)). Statistical analysis were performed T-student and a multiple linear regression model using STATA v13.1 and A1a post-ESWL score as dependent variable. Results: The sample included 95 patients, with a mean of 52 ± 13 years, 35 (36.84%) women, 60 (63.16%) men. 25 (26.32%) ureteral stones and 70 (73.68%) kidney. 42 (44.2%) received music. There were no significant differences between both groups regarding pre-ESWL variables or questionnaires scores. Table 1. Bivariate analysis Variable PreESWL A1a (Pain) PreESWL A2 (Anxiety) PostESWL A1a PostESWL A2 A3 (satisfaction)
Music
No Music
p Value
1,14 ± 1,75 2,86 ± 2,47 5,43 ± 2,31 0,98 ± 1,85 8,75 ± 1,58
1,13 ± 1,95 3,32 ± 2,74 5,32 ± 2,31 1,28 ± 1,74 7,94 ± 2,15
0,978 0,396 0,822 0,409 0,037
Patient’s satisfaction is higher with music. Linear regression model. Dependent
Variables
Coefficient
95% CI
PostESWL A1a
Renal Music Dolantine Age
1,08 -0,14 0,02 -0,03
0,05 – 2,13 -1,05 – 0,75 0,01 – 0,08 -0,07 – 0,01
p value = 0.003 . Music acts as an adjustment variable, there is a clear trend in reducing pain not reaching statistical significance probably due to a lack of sample.
Conclusions: Music could join standard analgesia during ESWL while increasing satisfaction among patients. More studies are needed to confirm these results. E10 Immediately extracorporeal lithotripsy in the treatment of renal colic Tabares Jiménez J.1, Bueno Serrano G.1, Buendia Gonzalez E.1, Charry Gonima P.2, Blazquez Vallejo C.3, Hernandez Sánchez J.E.4, Carbonero Garcia M.2, Sanchez Encias M.3, González Enguita C.1 1 Fundación Jiménez Diaz, Dept. of Urology, Madrid, Spain, 2Hospital Infanta Elena, Dept. of Urology, Madrid, Spain, 3Hospital Rey Juan Carlos, Dept. of Urology, Madrid, Spain, 4Hospital General De Villalba, Dept. of Urology, Madrid, Spain Introduction and objectives: Renal colic is an acute syndrome involving unilateral flank pain, linked to an obstrucion in the upper urinary tract. The pain is often intense. After having considered other diagnoses and checked for signs of complication (fever, oligoanuria), the first step is to control the pain. Nonsteroideal anti-anflammatory drugs are effective in patients may benefict with inmedialety extracorporeal shock wave lithotripsy. Evaluate immediately extracorporeal shock wave lithotripsy (i-ESWL) for the treatment of obstructing ureteral stones causin acute renal colic. Materials and methods: Between October 2014 and May 2015, 43 patients with a mean age of 39 years (range 19-83 years) were treated by i-ESWL for obstructing ureteral stones causin acute renal colic refractory to medical treatment or recurring within 24 hours of such treatment. Stones were visualised by fluoroscopic imaging. Follow up included radiological and/or ultrasound examinations. The mean stone size was 8,87 mm (range 3,5-13). The stone was located in the lumbar ureter in 56%, pelic ureter in 4,6 %, and sacro iliac 39%.
THURSDAY 10 SEPTEMBER 2015 / EUROPEAN UROLOGY SUPPLEMENTS 14 (2015) 29–78
E8 Comparison of the pain and anxiety scores between the first and second session SWL treatment for kidney stone patients Yilmaz Ö., Saraçoğlu F., Yeşildal C., Soydan H., Ateş F., Zor M., Şenkul T. Gata Haydarpasa Training Hospital, Dept. of Urology, Istanbul, Turkey Introduction and objectives: SWL plays a major role in the minimal invasive treatment of urinary stone disease, with adding a significant anxiety and pain. Moreover, sometimes these disadvantages may prevent an effectively performed SWL session. In this study we evaluated whether or not the anxiety and pain scores will be different between the first and second session SWL treatment. Materials and methods: Between March 2014 and January 2015, a total of 126 patients who underwent SWL treatment due to a 1-2 cm kidney stone included to the study. Patient anxiety and pain were evaluated with “hospital anxiety and depression scale (HADS)” and “visual analog score (VAS)” prior and during the therapy, respectively. Age, sex, body mass index (BMI), stone burden, applied energy and SW numbers were recorded. Results: First time SWL performed patients were conducted in group 1 and second time SWL performed patients in group2. There were 70 patients (56 male and 14 female) in group 1 and 56 patients (47 male and 9 female) in group 2. Age, sex, BMI and stone burden were similar between the two groups. While VAS scores were significantly lower (5,23±2,94 vs 6,41±2,37) in the second group, HADS scores were higher without statistical significance (6,39±3,49 vs 5,44±3,81) (Table 1). Table 1
Age BMI Stone burden Sex M F HASD score VAS score
1. session SWL
2.session SWL
p
42,34±15,07 26,18±4,17 10,14±4,37 n: 56 %80 n: 14 %20 5,44±3,81 6,41±2,37
43,23±15,08 26,63±4,34 8,86±4,25 n: 47 %83.90 n: 9 %16.10 6,39±3,49 5,23±2,94
0,550 0,750 0,099 0.570 0,091 0,030*
*p<0.05: Statistical significance
Conclusions: First timers of SWL treatment experience higher pain and this probably leads higher anxiety in the second session. Better pain control during the first session will probably lead successfully completed first sessions and a consistence to continue the future treatment sessions. E9 Music as analgesia during ESWL a randomized clinical trial Betancourt Hernández J., Budia Alba A., Trassierra Villa M., Bahílo P., López-Acón J.D., Álvarez A., Boronat Tormo F. Hospital Universitari i Politècnic La Fe, Dept. of Urology, Valencia, Spain Introduction and objectives: To establish if music decreases pain during a session of extracorporeal shock wave lithotripsy (ESWL) and improves the satisfaction rate. Materials and methods: Simple randomization controlled clinical trial, including patients with ureteral or kidney stones attending the first session of ESWL from September 2014 to December 2014. Two groups, one received standard analgesia and headphones choosing between 5 different types of music played during the entire session, the other received standard analgesia only. The variables recorded were age, gender, two questionnaires before and after ESWL with two pain questions (Likert scale of 0-10 (A1a) and visual analogue scale (A1b) as cross-check) and a third on anxiety (Likert (A2) 0-10). Also heart
rate (HR), respiratory rate (RR), blood pressure (systolic (SBP), diastolic (DBP), interruption of procedure, total dolantine (mg), secondary analgesia, intensity (Hz). The questionnaires were administered before and after ESWL with an extra post-ESWL question about treatment satisfaction (Likert scale of 0-10 (A3)). Statistical analysis were performed T-student and a multiple linear regression model using STATA v13.1 and A1a post-ESWL score as dependent variable. Results: The sample included 95 patients, with a mean of 52 ± 13 years, 35 (36.84%) women, 60 (63.16%) men. 25 (26.32%) ureteral stones and 70 (73.68%) kidney. 42 (44.2%) received music. There were no significant differences between both groups regarding pre-ESWL variables or questionnaires scores. Table 1. Bivariate analysis Variable PreESWL A1a (Pain) PreESWL A2 (Anxiety) PostESWL A1a PostESWL A2 A3 (satisfaction)
Music
No Music
p Value
1,14 ± 1,75 2,86 ± 2,47 5,43 ± 2,31 0,98 ± 1,85 8,75 ± 1,58
1,13 ± 1,95 3,32 ± 2,74 5,32 ± 2,31 1,28 ± 1,74 7,94 ± 2,15
0,978 0,396 0,822 0,409 0,037
Patient’s satisfaction is higher with music. Linear regression model. Dependent
Variables
Coefficient
95% CI
PostESWL A1a
Renal Music Dolantine Age
1,08 -0,14 0,02 -0,03
0,05 – 2,13 -1,05 – 0,75 0,01 – 0,08 -0,07 – 0,01
p value = 0.003 . Music acts as an adjustment variable, there is a clear trend in reducing pain not reaching statistical significance probably due to a lack of sample.
Conclusions: Music could join standard analgesia during ESWL while increasing satisfaction among patients. More studies are needed to confirm these results. E10 Immediately extracorporeal lithotripsy in the treatment of renal colic Tabares Jiménez J.1, Bueno Serrano G.1, Buendia Gonzalez E.1, Charry Gonima P.2, Blazquez Vallejo C.3, Hernandez Sánchez J.E.4, Carbonero Garcia M.2, Sanchez Encias M.3, González Enguita C.1 1 Fundación Jiménez Diaz, Dept. of Urology, Madrid, Spain, 2Hospital Infanta Elena, Dept. of Urology, Madrid, Spain, 3Hospital Rey Juan Carlos, Dept. of Urology, Madrid, Spain, 4Hospital General De Villalba, Dept. of Urology, Madrid, Spain Introduction and objectives: Renal colic is an acute syndrome involving unilateral flank pain, linked to an obstrucion in the upper urinary tract. The pain is often intense. After having considered other diagnoses and checked for signs of complication (fever, oligoanuria), the first step is to control the pain. Nonsteroideal anti-anflammatory drugs are effective in patients may benefict with inmedialety extracorporeal shock wave lithotripsy. Evaluate immediately extracorporeal shock wave lithotripsy (i-ESWL) for the treatment of obstructing ureteral stones causin acute renal colic. Materials and methods: Between October 2014 and May 2015, 43 patients with a mean age of 39 years (range 19-83 years) were treated by i-ESWL for obstructing ureteral stones causin acute renal colic refractory to medical treatment or recurring within 24 hours of such treatment. Stones were visualised by fluoroscopic imaging. Follow up included radiological and/or ultrasound examinations. The mean stone size was 8,87 mm (range 3,5-13). The stone was located in the lumbar ureter in 56%, pelic ureter in 4,6 %, and sacro iliac 39%.