Pain Relief During Cystoscopic Ureteral Stent Extraction by Transcutaneous Electrical Acupoint Stimulation: A...

Area of Science:

• Urology
• Pain Management
• Complementary and Alternative Medicine

Background:

• Acupuncture is known for pain relief, but its application via transcutaneous electrical acupoint stimulation (TEAS) for pain during ureteral stent removal is unstudied.
• Ureteral stent extraction is often associated with pain, necessitating effective pain management strategies.
• Evaluating TEAS efficacy is crucial for non-pharmacological pain relief in urological procedures.

Purpose of the Study:

• To assess the effectiveness of TEAS in alleviating pain during cystoscopic ureteral stent extraction.
• To compare TEAS at specific acupoint combinations (LI4/PC6 and SP6/ST36) against a sham procedure.

Main Methods:

• A prospective, double-blinded, randomized controlled trial involving 122 patients undergoing ureteral stent removal.
• Patients were randomized into three groups: TEAS at LI4/PC6, TEAS at SP6/ST36, or sham TEAS, administered 30 minutes pre-procedure.
• Pain was measured using the Visual Analog Scale (VAS) at key time points: cystoscope insertion (T1), stent removal (T2), and 10 minutes post-procedure (T3).

Main Results:

• Both TEAS groups demonstrated significantly lower VAS pain scores during stent removal (T2) and 10 minutes post-procedure (T3) compared to the sham group (p=0.027 and p=0.012, respectively).
• A significant Time × Gender interaction (p=0.006) indicated that the temporal pattern of pain reduction varied between males and females, with a more pronounced effect in females.
• No significant differences in hemodynamic parameters were observed, and TEAS was well-tolerated, with no age-related variations in efficacy.

Conclusions:

• TEAS is an effective non-pharmacological adjunct for reducing procedural and post-procedural pain during cystoscopic ureteral stent extraction.
• The analgesic effect of TEAS exhibits gender-specific temporal patterns, suggesting tailored application may be beneficial.
• TEAS is safe and warrants consideration as an adjunct therapy in outpatient urological settings, with further multicenter studies recommended.