Re: Preoperative Belladonna and Opium Suppository for Ureteral Stent Pain: A Randomized, Double-Blinded, Placebo-Controlled Study

Re: Preoperative Belladonna and Opium Suppository for Ureteral Stent Pain: A Randomized, Double-Blinded, Placebo-Controlled Study

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Urolithiasis/Endourology Re: Validation of a Functional Pyelocalyceal Renal Model for the Evaluation of Renal Calculi Passage while Riding a Roller Coaster M. A. Mitchell and D. D. Wartinger Doctors Clinic, Poulsbo, Washington, and Department of Osteopathic Surgical Specialties, Michigan State University College of Osteopathic Medicine, East Lansing, Michigan J Am Osteopath Assoc 2016; 116: 647e652. doi: 10.7556/jaoa.2016.128

Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27669068 Editorial Comment: This in vitro model demonstrates that physical forces may prompt kidney stone motion. Clinical studies are currently being conducted assessing ultrasound energy displacement of kidney stones. Inversion, mechanical vibration and diuresis have previously been found to augment passage of lower pole renal stone fragments. Dean G. Assimos, MD

Suggested Reading Pace KT, Tariq N, Dyer SJ et al: Mechanical percussion, inversion and diuresis for residual lower pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. J Urol 2001; 166: 2065. Harper JD, Cunitz BW, Dunmire B et al: First in human clinical trial of ultrasonic propulsion of kidney stones. J Urol 2016; 195: 956. Connors BA, Evan AP, Blomgren PM et al: Comparison of tissue injury from focused ultrasonic propulsion of kidney stones versus extracorporeal shock wave lithotripsy. J Urol 2014; 191: 235.

Re: Preoperative Belladonna and Opium Suppository for Ureteral Stent Pain: A Randomized, Double-Blinded, Placebo-Controlled Study F. C. Lee, S. K. Holt, R. S. Hsi, B. M. Haynes and J. D. Harper Department of Urology, University of Washington School of Medicine, Seattle, Washington Urology 2016; Epub ahead of print. doi: 10.1016/j.urology.2016.07.035

Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27658661 Editorial Comment: This placebo controlled study showed that a single belladonna and opium suppository administered just before ureteroscopy resulted in less pain with urination, better quality of life and a better quality of work score. The subjects in both groups were also treated with tamsulosin. These results may be due to preemptive treatment of pain. Thus, these may be additional ingredients for a stent pain cocktail! Dean G. Assimos, MD

0022-5347/17/1974-0001/0 THE JOURNAL OF UROLOGY® Ó 2017 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION

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RESEARCH, INC.

http://dx.doi.org/10.1016/j.juro.2016.12.107 Vol. 197, 1-2, April 2017 Printed in U.S.A.

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Suggested Reading Krambeck AE, Walsh RS, Denstedt JD et al: A novel drug eluting ureteral stent: a prospective, randomized, multicenter clinical trial to evaluate the safety and effectiveness of a ketorolac loaded ureteral stent. J Urol 2010; 183: 1037. Sivalingam S, Streeper NM, Sehgal PD et al: Does combination therapy with tamsulosin and tolterodine improve ureteral stent discomfort compared with tamsulosin alone? A double-blind, randomized, controlled trial. J Urol 2016; 195: 385.

Re: Urolithiasis Treatment in Australia: The Age of Ureteroscopic Intervention M. Perera, N. Papa, N. Kinnear, D. Wetherell, N. Lawrentschuk, D. Webb and D. Bolton Department of Surgery, Austin Health, University of Melbourne, Olivia Newton-John Cancer Research Institute and Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia J Endourol 2016; 30: 1194e1199. doi: 10.1089/end.2016.0513

Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27629239 Editorial Comment: Performance of stone removing procedures has increased in Australia and the majority of procedures are ureteroscopic. This finding is consistent with North American trends and is likely driven by ureteroscopy being a point of service procedure with favorable comparative effectiveness. Dean G. Assimos, MD

Suggested Reading Ordon M, Urbach D, Mamdani M et al: A population based study of the changing demographics of patients undergoing definitive treatment for kidney stone disease. J Urol 2015; 193: 869. Matlaga BR: Contemporary surgical management of upper urinary tract calculi. J Urol 2009; 181: 2152.

Re: Postpercutaneous Nephrolithotomy Systemic Inflammatory Response Syndrome is Not Associated with Unplanned Readmission R. A. Moses, D. Agarwal, E. P. Raffin, B. R. Viers, V. Sharma, A. E. Krambeck and V. M. Pais, Jr. Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, and Department of Urology, Mayo Clinic, Rochester, Minnesota Urology 2016; Epub ahead of print. doi: 10.1016/j.urology.2016.09.012

Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27641935 Editorial Comment: This retrospective study demonstrated that patients who manifest systemic inflammatory response syndrome after percutaneous nephrolithotomy are not at increased risk for readmission to the hospital compared to those who do not display this response. The only factor observed to be predictive of readmission was presence of struvite stones. The presence of a positive stone culture, which is observed in the majority of patients harboring struvite calculi, is a known risk factor for systemic inflammatory response syndrome after percutaneous nephrolithotomy. The limitations of this study are that it was retrospective, and thus things were not done in a standard manner. Dean G. Assimos, MD

Suggested Reading Mariappan P, Smith G, Bariol SV et al: Stone and pelvic urine culture and sensitivity are better than bladder urine as predictors of urosepsis following percutaneous nephrolithotomy: a prospective clinical study. J Urol 2005; 173: 1610.

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