JCU - January 2022 - 17

Ghaed et al.
17
Figure 3. The trend, error bar, and mean international prostate symptom score (IPSS) at baseline, 2 and 4 weeks.
insertion was assessed among 128 patients. Two weeks after
drug administration, the VAS and IPSS were similar in all
case groups including tamsulosin, cystone and dual therapy;
however, the cystone group had lower VAS scores after 4
weeks. The underlying mechanism may be that cystone is
related to the removal of crystalurea, and small stone passage
besides the diuretic and anti-spasmodic effects.8
The study by Shalaby et al.9 in 338 patients with double-J
stent insertion showed that the efficacy of tamsulosin, solifenacin
and their combination was good for the relief of
lower urinary tract symptoms. In addition, in their study, all
groups had a significant difference with the control group.
Dellis et al.10 assessed the efficacy of tamsulosin, solifenacin
and their combination and similarly reported good
efficacy in the control group and worse efficacy in the placebo
group with a significant difference versus the other
groups. Sengupta8 reported good efficacy for cystone
alone versus a combination of cystone and antibiotic (75%
vs. 79.2%). This matter was due to some anti-microbial
effects of cystone.
The study by Aggarwal et al.11 compared tadalafil versus
tamsulosin and found good similar efficacies for both
groups. However the effects of tadalafil were better than
tamsulosin to improve the sexual symptoms and body pain.
Garg and Singh12 reported good efficacy for cystone and
65.8% were improved in urinary symptoms after 5 days of
treatment. Also, cystone alone was more effective than
antiseptic alone in improving the symptoms, but their
combination was more effective than each one alone. In our
study the pain, quality of life and total IPSS were improved
more in the intervention versus the placebo group.12-16
Our study is the first research in the literature, which
determines the efficacy of cystone in double-J-induced
lower urinary tract symptoms. Moreover, the results of this
study demonstrated that despite the painful status of double-J
stent insertion, the voiding and storage symptoms
were improved by cystone or tamsulosin or their combination,
leading to better improvement in the total IPSS and
VAS. Also, the administration of each one of these drugs
led to decreased pain and increased quality of life in
patients. It was found that in all patients, the urinary symptoms
and pain were intensified after 2 weeks but they were
decreased after 4 weeks in the drug versus placebo groups.
The small sample size and difficulty in follow-up of the
patients were the major limitations of our study. Further
studies on the other clinical symptoms and side effects
with a larger sample size are required to attain more definite
comparative results.
Conclusions
Both tamsulosin and cystone are efficient drugs which
would relieve stent-related lower urinary tract symptoms.
The administration of cystone with or without tamsulosin
for 4 weeks may have the best results in reducing the VAS
and IPSS.

JCU - January 2022

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JCU - January 2022 - Cover1
JCU - January 2022 - Contents
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