Litotricia por ondas de choque con música: un tratamiento menos doloroso y más satisfactorio / Shockwave lithotripsy with music: Less painful and more satisfactory treatment

Introducción: El objetivo del estudio fue determinar si escuchar música durante una sesión de litotricia extracorpórea por ondas de choque (LEOC) mejora el dolor de los pacientes. Material y método: Se realizó una aleatorización simple y oculta de pacientes con litiasis renales o ureterales que acudieron por vez primera a una sesión de LEOC de 7.000 ondas, entre septiembre y diciembre de 2014. Un grupo recibió música mientras que el otro no. Se registraron la edad, sexo, localización de la litiasis (renal/ureteral) y 2 cuestionarios pre-LEOC (cuestionario A) y post-LEOC (cuestionario B). Cada cuestionario contiene una pregunta sobre ansiedad y otra sobre dolor en escala Likert (0 al 10). El B, además, contiene otra sobre satisfacción y otra sobre comodidad (Likert 0 al 10). Otras variables fueron la frecuencia cardiaca, respiratoria, tensión arterial sistólica y diastólica en la onda 2.000, 5.000 y 7.000, causa de interrupción del procedimiento, petidina total (mg), analgesia secundaria, energía (J) y frecuencia (Hz). Se realizó un análisis bivariante con t de Student, X2/Fisher y un modelo de regresión lineal múltiple. Resultados: La muestra incluyó a 95 pacientes, con una media de edad de 52 años (±13), 35 mujeres (36,84%), 60 hombres (63,2%); 25 para litiasis ureterales (26,3%) y 70 (26,3%) para renales (73,7%). Un total de 42 pacientes (44,2%) pacientes recibieron música. No hubo diferencias entre las variables demográficas ni en las puntuaciones del cuestionario A. La satisfacción y el dolor fueron mejores en el cuestionario B con música. Conclusión: La música es capaz de disminuir el dolor y mejorar la satisfacción del paciente en los tratamientos con LEOC. Más estudios son necesarios para comprobar este efecto

Introduction: The objective of this study was to determine whether listening to music during a session of extracorporeal shockwave lithotripsy (ESWL) improves patients' pain. Material and method: A simple, blind randomisation was undertaken of patients with kidney and ureter stones attending an ESWL session of 7,000 waves for the first time, between September and December 2014. One group was given music and the other was not. The age, gender, location of stones (kidney/ureter) were recorded and 2 questionnaires: pre ESWL (questionnaire A) and postESWL (questionnaire B). Each questionnaire contained a question about anxiety and another question on pain on the Likert scale (0-10). Questionnaire B also had a question on satisfaction and comfort (Likert 0-10). Other variables included heart rate, respiratory rate, systolic and diastolic blood pressure on wave 2,000, 5,000 and 7,000, reason for halting the procedure, total pethidine (mg), secondary analgesia, energy (J) and frequency (Hz). Bivariate analysis using the Student's t-test, X2/Fisher test and a multiple linear regression model. Results: The sample comprised 95 patients, with a mean age of 52 (±13) years, 35 (36.84%) females, 60 (63.2%) males. A total of 25 (26.3%) ureter stones and 70 (73.7%) kidney stones. A number of 42 (44.2%) patients were given music. There were no differences between the demographic variables or questionnaire A scores. Satisfaction and pain were better on questionnaire B with music. Conclusion: Music can reduce pain and improve patient satisfaction in ESWL treatment. More studies are required to confirm this effect

Shockwave lithotripsy with music: Less painful and more satisfactory treatment. / Litotricia por ondas de choque con música: un tratamiento menos doloroso y más satisfactorio.

INTRODUCTION: The objective of this study was to determine whether listening to music during a session of extracorporeal shockwave lithotripsy (ESWL) improves patients' pain. MATERIAL AND METHOD: A simple, blind randomisation was undertaken of patients with kidney and ureter stones attending an ESWL session of 7,000 waves for the first time, between September and December 2014. One group was given music and the other was not. The age, gender, location of stones (kidney/ureter) were recorded and 2questionnaires: pre ESWL (questionnaire A) and postESWL (questionnaire B). Each questionnaire contained a question about anxiety and another question on pain on the Likert scale (0-10). Questionnaire B also had a question on satisfaction and comfort (Likert 0-10). Other variables included heart rate, respiratory rate, systolic and diastolic blood pressure on wave 2,000, 5,000 and 7,000, reason for halting the procedure, total pethidine (mg), secondary analgesia, energy (J) and frequency (Hz). Bivariate analysis using the Student's t-test, X2/Fisher test and a multiple linear regression model. RESULTS: The sample comprised 95 patients, with a mean age of 52 (±13) years, 35 (36.84%) females, 60 (63.2%) males. A total of 25 (26.3%) ureter stones and 70 (73.7%) kidney stones. A number of 42 (44.2%) patients were given music. There were no differences between the demographic variables or questionnaire A scores. Satisfaction and pain were better on questionnaire B with music. CONCLUSION: Music can reduce pain and improve patient satisfaction in ESWL treatment. More studies are required to confirm this effect.

[Treatment of benign hyperplasia of the prostate using thermal transurethral needle ablation (TUNA)]. / Tratamiento de la hiperplasia benigna de próstata mediante ablación térmica transuretral con aguja (TUNA).

Transurethral needle ablation of the prostate (TUNA) is a new, fast and minimally invasive device that produce a selective necrosis of the prostatic gland by delivering low level radiofrequency energy. We describe our experience with this new technique. A total of 42 patients suffering from symptomatic BPH were treated with this procedure. The original generator was used in 27 patients (group 1). A new generator allowing a more homogeneous application of intraprostatic temperature was used in 15 patients (group 2). The patients pretreatment evaluation consisted of World Health Organization symptom score and quality of life, digital rectal examination, uroflowmetric parameters, residual volume, transrectal ultrasound and PSA. Follow-up was performed using the same pretreatment parameters at one month, three months, six months and twelve months. All patients were treated using urethral xylocaine with intravenous or intramuscular sedation (petidine clorhidrate) and tolerance was good. IPSS and quality of life decreased significantly in both groups at first month after treatment and kept low up to twelve-month control. Peak flow rate increased from 7.7 +/- 3.7 ml/sec to 10 +/- 4.1 ml/sec at the twelve-month control in group 1 (p > 0.05), and from 7.6 +/- 2 ml/sec to 9.8 +/- 3.3 ml/sec in group 2 (p > 0.05). Residual volume decrease was statistically significant in group 2 (p < 0.05). No significant complications were encountered. Five patients in group 1 and one patient in group 2 required TURP some time in the follow-up (14%). In our experience, after one year of follow-up, improvement in subjective parameters is evident, although uroflowmetric improvement is moderate and with no statistically significance. No differences were found between both groups of treatment.