ABSTRACT
OBJECTIVES: To determine if the duration of wearing compression stockings after endovenous laser ablation (EVLA) of the great saphenous vein (GSV) has influence on pain and quality of life. METHODS: This was a prospective randomized controlled trial. Between December 2006 and February 2008, 109 consecutive patients with EVLA of the GSV were analyzed. Deep vein insufficiency, ulceration, more than one insufficient vein in one leg, and use of anticoagulants were exclusion criteria. Group A used compression stocking for 48 hours after therapy, group B for 7 days. Pain (visual analogue scale [VAS]) and quality of life (SF-36) were analyzed 48 hours, 1 week, and 6 weeks after therapy. Three months after treatment, duplex ultrasound imaging was performed to assess occlusion rates. RESULTS: Both groups (group A, n = 37; group B, n = 32) where comparable at baseline. After 1 week, there was a significant difference in pain (VAS score 3.7 [± 2.1] vs. 2.0 [± 1.1], p ≤ .001), and physical dysfunction (group A, 85.1 [± 11.2] vs. group B, 95.7 [± 10.1]; p < .001) as well as vitality (group A, 75 [± 13.0] vs. group B, 83.7 [± 13.4]; p = .03), all in favor of group B, which disappeared after 6 weeks. After 6 weeks, no significant differences in all endpoints were present. Duplex ultrasound imaging revealed complete GSV occlusion in all patients, while no cases of deep venous thrombosis had developed. CONCLUSIONS: Prescribing compression stockings for longer than 2 days after endovenous GSV ablation (without simultaneous phlebectomies) leads to reduced pain and improved physical function during the first week after treatment.
Subject(s)
Laser Therapy , Saphenous Vein/surgery , Stockings, Compression , Venous Insufficiency/surgery , Adult , Chi-Square Distribution , Humans , Laser Therapy/adverse effects , Middle Aged , Netherlands , Pain Measurement , Pain, Postoperative/etiology , Pain, Postoperative/prevention & control , Predictive Value of Tests , Prospective Studies , Quality of Life , Saphenous Vein/diagnostic imaging , Surveys and Questionnaires , Time Factors , Treatment Outcome , Ultrasonography, Doppler, Duplex , Venous Insufficiency/diagnosisABSTRACT
Selective postsynaptic alpha1-adrenergic blocking agents such as tamsulosin are mainly used for treating micturition symptoms due to prostatic hyperplasia. They are also used off-label in patients with a distal ureteral stone to enhance passage of the stone. This application is based on the smooth muscle relaxant effect of alpha1-receptor blockade. Smooth muscle relaxation in the penis leads to penile tumescence. The case was reported of a 47-year-old man with a distal ureteral stone who presented with priapism after using tamsulosin 0.4 mg once daily for 9 days. Male patients receiving off-label alpha1-blocking agents should be informed about this adverse effect.