title: A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: a prospective, randomised, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  To determine the incidence of severe pain after ureteric stent removal. To evaluate the efficacy of a single dose of a non-steroidal anti-inflammatory drug (NSAID) in preventing this complication.
  
  
  METHODS
  A prospective, randomised, double-blind, placebo-controlled trial was performed at our institution. Adults with an indwelling ureteric stent after ureteroscopy were randomised to receive either a single dose of placebo or an NSAID (rofecoxib 50 mg) before ureteric stent removal. Pain was measured using a visual analogue scale (VAS) just before and 24 h after stent removal Pain medication use after ureteric stent removal was measured using morphine equivalents.
  
  
  RESULTS
  In all, 22 patients were enrolled and randomised into the study before ending the study after interim analysis showed significant decrease in pain level in the NSAID group. The most common indication for ureteroscopy was urolithiasis (14 patients). The proportion of patients with severe pain (VAS score of ≥7) during the 24 h after ureteric stent removal was six of 11 (55%) in the placebo group and it was zero of 10 in the NSAID group (P < 0.01). There were no complications related to the use of rofecoxib.
  
  
  CONCLUSIONS
  We found a 55% incidence of severe pain after ureteric stent removal. A single dose of a NSAID before stent removal prevents severe pain after ureteric stent removal.
authors.affiliation: Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Nicholas N
authors.initials: NN
authors.lastname: Tadros
authors.forename: Lisa
authors.initials: L
authors.lastname: Bland
authors.forename: Edith
authors.initials: E
authors.lastname: Legg
authors.forename: Ali
authors.initials: A
authors.lastname: Olyaei
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Conlin
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage*; D020878:Device Removal / Q000009:adverse effects*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007783:Lactones / Q000008:administration & dosage*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D015607:Stents; D013450:Sulfones / Q000008:administration & dosage*; D014513:Ureter; D018666:Ureteroscopy; D052878:Urolithiasis / Q000601:surgery
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib