[SS-066]

Progesterone Surge Decreases the Severity of Ureteral Stent Related Symptoms in Female Patients

Emrah Yürük, Aykut Çolakerol, Ege Can Şerefoğlu
Department of Urology, Bagcilar Training and Research Hospital, Istanbul

INTRODUCTION: Ureteral stents are widely used after ureteral manipulation. However, most of the patients report some degree of discomfort related to these stents. It is well known that progesterone causes relaxation of the smooth muscles of the urinary tract, including the ureters.
AIM: To evaluate whether the progesterone surge seen during the luteal phase of the menstrual cycle decreases the severity of stent related symptoms.
PATIENTS and METHODS: Between May 2014 - October 2015, female patients aged 18 to 40 years, who required ureteral stent placement, were included to the study. Patients who were pregnant, using oral contraceptives or experiencing irregular menstrual cycles were excluded. Patients using anticholinergic or alpha-receptor blocking drugs were also excluded, along with the ones who required daily analgesic administration. All patients recorded the date of their last menstruation and they are instructed to complete the visual analogue scale (VAS, 0-10) scores twice per day postoperatively for a period of one month.
RESULTS: A total of 32 patients with a mean age of 29.28±5.98 (range: 18-41) recorded daily VAS scores. After exclusion of 3 patients because of frequent analgesic use, 29 patients were included. Indication of ureteral stent placement was flexible ureteroscopy in 9 (31%), percutaneous nephrolithotomy in 1 (3.4%), ureteroscopy in 11 (37.9%), ureteral stricture in 1 (3.4%), shock-wave lithotripsy in 5 (17.2%) and gynecologic pathologies in 2 (6.8%) patients. When compared to menstruation day, the VAS score was significantly lower on 24th (p=0.011, r=0.586), 25th (p=0.043, r=0.482), 26th (p=0.001, r=0.722) and 27th (p=0.0001, r=0.801) days. The daily VAS score changes were showed on Figure-1.
CONCLUSION: Progesterone surge seen during the luteal phase of the menstrual cycle seems to decrease stent related symptoms in female patients.


Şekil 1

The correlation of visual analogue scale score (VAS Score) with plasma progesterone levels