Clinical trial NCT02598102: Efficacy of Preprocedural Diclofenac in Males Undergoing Double J Stent Removal Under Local Anesthesia
Official title: Efficacy of Preprocedural Diclofenac in Males Undergoing Double J Stent Removal Under Local Anesthesia
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Pain
Lead sponsor: Institute of Nephro Urology, Bangalore
Sponsor class: OTHER_GOV
First posted: 2015-11-05
Enrollment: 150
Sex: MALE
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Double J (DJ) stents are placed following upper urinary tract surgeries. DJ stents are usually removed under local anesthesia using rigid cystoscope. Patients experience a lot of pain during this procedure and also continue to have discomfort during voiding for few days. The use of lignocaine jelly during this procedure is not very effective. Use of diclofenac suppository during flexible cystoscopy has been proven to be effective. This study was done to assess the effect of oral diclofenac in pain relief in patients undergoing DJ stent removal by rigid cystoscopy when compared to placebo and to assess its safety in these patients

Detailed description: Consecutive consenting male patients undergoing DJ stent removal under local anesthesia during 2014-15 were enrolled. Patients were randomized to receive 75 mg oral diclofenac or placebo 1 hour prior to procedure by double blind randomization. Intraurethral 2% lignocaine jelly (25 ml) was used in both groups. Pain during rigid cystoscopy, pain at first void and at 24 hours after cystoscopy was assessed using visual analogue scale \[VAS\] (0 to 100). Adverse reactions to diclofenac and episodes of acute urinary retention, if any, were assessed.

Eligibility criteria: Inclusion Criteria:

All consecutive consenting male patients aged more than 18 years, undergoing DJ stent removal under local anesthesia (2% Lignocaine jelly) during the study period will be included.

Exclusion Criteria:

* Patients unable to understand visual analogue pain score
* Age \< 18 years
* Presence of Lower Urinary Tract Symptoms prior to surgery
* Presence of prostatitis or urethral stricture during cystoscopy
* Patients with renal failure (Serum creatinine \> 1.3 mg/dl)
* Patients on concomitant nephrotoxic drugs
* Patients with history of peptic ulcer or upper gastrointestinal bleed or upper abdominal surgeries
* Loss to follow up at 24 hours following DJ stent removal

Primary outcomes:
measure: Pain
timeFrame: Intraoperative upto 24 hours postoperative
Secondary outcomes:
measure: Adverse reactions
timeFrame: 24 hours
Other outcomes:
Locations:
city: Bangalore
country: India
facility: Institute of Nephro Urology
state: Karnataka
Study officials:
affiliation: Postgraduate in Urology
name: VS Karthikeyan
role: PRINCIPAL_INVESTIGATOR
References:
citation: Chen YT, Hsiao PJ, Wong WY, Wang CC, Yang SS, Hsieh CH. Randomized double-blind comparison of lidocaine gel and plain lubricating gel in relieving pain during flexible cystoscopy. J Endourol. 2005 Mar;19(2):163-6. doi: 10.1089/end.2005.19.163.
citation: Karthikeyan VS, Keshavamurthy R, Mallya A, Chikka Moga Siddaiah M, Kumar S, Chandrashekar CR. Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial. Indian J Urol. 2017 Jan-Mar;33(1):53-57. doi: 10.4103/0970-1591.194783.