Author reply: Letter to editor on the effect of corticosteroid on postoperative early pain, renal colic and total analgesic consumption after uncomplicated and unstented ureteroscopy: a matched-pair analysis by Mark C. Kendall

Author reply: Letter to editor on the effect of corticosteroid on postoperative early pain, renal... World Journal of Urology https://doi.org/10.1007/s00345-018-2356-x LE T TER TO  THE   EDITOR Author reply: Letter to editor on the effect of corticosteroid on postoperative early pain, renal colic and total analgesic consumption after uncomplicated and unstented ureteroscopy: a matched‑pair analysis by Mark C. Kendall Nurullah Hamidi Received: 21 May 2018 / Accepted: 25 May 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Dear Editor, We did not give intraoperative dexamethasone. As men- tioned in the discussion section of our article, dexametha- We would like to thank to Dr. Kendall for his thought- sone is one of the long-acting corticosteroid. Long-acting ful and insightful comments regarding our study [1]. corticosteroids have higher risk in term of permanent side Dr. Kendall mentioned that there are some questions that effect such as adrenocortical insufficiency compared with need to be clarified [ 2]. I appreciate the comments and ques- short-acting corticosteroid [3]. On the other hand, methyl- tions and hope that the answers provided will help address prednisolone is used routinely at many clinic in our coun- any concerns. try to prevent postoperative edema at surgical area. Based Dr. Kendall raises the concern of standardization of intra- on these, we preferred to give methylprednisolone to our operative analgesics, which may have a significant effect on patients. postoperative outcome regarding pain. At our institution, Finally, I agree with Dr. Kendall regarding the statistical anesthesiologists follow a standard intraoperative analgesia analysis. protocol for all ureterorenoscopy procedures. Our anesthesi- ologists give routinely intraoperative opioid (Remifentanil) Compliance with ethical standards to all ureterorenoscopy patients. Actually, we do not expect Conflict of interest I declare that they have no conflict of interest. of opioids given to patients of both group will change the statistical results. However, we gave diclofenac sodium (p.o.) and alpha blockers preoperatively to some patients as medi- References cal expulsive therapy to reduce requirement of ureterorenos- copy procedure. This may significantly affect the preopera - 1. Hamidi N, Ozturk E, Yikilmaz TN, Atmaca AF, Basar H (2018) tive (basal) pain scores of our patients. When we reviewed The effect of corticosteroid on postoperative early pain, renal our patients’ data, we observed similar medical expulsive colic and total analgesic consumption after uncomplicated and therapy rate for two groups (25 and 27.7% for group I and unstented ureteroscopy: a matched-pair analysis. World J Urol 2:1–6. https ://doi.org/10.1007/s0034 5-018-2210-1 group II, respectively). In our study, mean preoperative pain 2. Kendall Mark C (2018) Comment on: “The effect of corticoster - scores for both group were statistically similar (p = 0.77). oid on postoperative early pain, renal colic and total analgesic Another question of Dr. Kendall is about our patients consumption after uncomplicated and unstented ureteroscopy: received intraoperative dexamethasone whether or did not. a matched-pair analysis”. World J Urol. https ://doi.org/10.1007/ s0034 5-018-2324-5 3. Dora L, Alexandra A, Leanne W et al (2013) A practical guide to the monitoring and management of the complications of systemic This reply refers to the comment available at https ://doi. corticosteroid therapy. Allergy Asthma Clin Immunol 9:30 org/10.1007/s0034 5-018-2324-5. * Nurullah Hamidi dr.nhamidi86@gmail.com Department of Urology, Atatürk Training and Research Hospital, Universiteler Mah, No:1, Cankaya, 06430 Ankara, Turkey Vol.:(0123456789) 1 3 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png World Journal of Urology Springer Journals

Author reply: Letter to editor on the effect of corticosteroid on postoperative early pain, renal colic and total analgesic consumption after uncomplicated and unstented ureteroscopy: a matched-pair analysis by Mark C. Kendall

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2018 by Springer-Verlag GmbH Germany, part of Springer Nature
Subject
Medicine & Public Health; Urology; Nephrology; Oncology
ISSN
0724-4983
eISSN
1433-8726
D.O.I.
10.1007/s00345-018-2356-x
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Abstract

World Journal of Urology https://doi.org/10.1007/s00345-018-2356-x LE T TER TO  THE   EDITOR Author reply: Letter to editor on the effect of corticosteroid on postoperative early pain, renal colic and total analgesic consumption after uncomplicated and unstented ureteroscopy: a matched‑pair analysis by Mark C. Kendall Nurullah Hamidi Received: 21 May 2018 / Accepted: 25 May 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Dear Editor, We did not give intraoperative dexamethasone. As men- tioned in the discussion section of our article, dexametha- We would like to thank to Dr. Kendall for his thought- sone is one of the long-acting corticosteroid. Long-acting ful and insightful comments regarding our study [1]. corticosteroids have higher risk in term of permanent side Dr. Kendall mentioned that there are some questions that effect such as adrenocortical insufficiency compared with need to be clarified [ 2]. I appreciate the comments and ques- short-acting corticosteroid [3]. On the other hand, methyl- tions and hope that the answers provided will help address prednisolone is used routinely at many clinic in our coun- any concerns. try to prevent postoperative edema at surgical area. Based Dr. Kendall raises the concern of standardization of intra- on these, we preferred to give methylprednisolone to our operative analgesics, which may have a significant effect on patients. postoperative outcome regarding pain. At our institution, Finally, I agree with Dr. Kendall regarding the statistical anesthesiologists follow a standard intraoperative analgesia analysis. protocol for all ureterorenoscopy procedures. Our anesthesi- ologists give routinely intraoperative opioid (Remifentanil) Compliance with ethical standards to all ureterorenoscopy patients. Actually, we do not expect Conflict of interest I declare that they have no conflict of interest. of opioids given to patients of both group will change the statistical results. However, we gave diclofenac sodium (p.o.) and alpha blockers preoperatively to some patients as medi- References cal expulsive therapy to reduce requirement of ureterorenos- copy procedure. This may significantly affect the preopera - 1. Hamidi N, Ozturk E, Yikilmaz TN, Atmaca AF, Basar H (2018) tive (basal) pain scores of our patients. When we reviewed The effect of corticosteroid on postoperative early pain, renal our patients’ data, we observed similar medical expulsive colic and total analgesic consumption after uncomplicated and therapy rate for two groups (25 and 27.7% for group I and unstented ureteroscopy: a matched-pair analysis. World J Urol 2:1–6. https ://doi.org/10.1007/s0034 5-018-2210-1 group II, respectively). In our study, mean preoperative pain 2. Kendall Mark C (2018) Comment on: “The effect of corticoster - scores for both group were statistically similar (p = 0.77). oid on postoperative early pain, renal colic and total analgesic Another question of Dr. Kendall is about our patients consumption after uncomplicated and unstented ureteroscopy: received intraoperative dexamethasone whether or did not. a matched-pair analysis”. World J Urol. https ://doi.org/10.1007/ s0034 5-018-2324-5 3. Dora L, Alexandra A, Leanne W et al (2013) A practical guide to the monitoring and management of the complications of systemic This reply refers to the comment available at https ://doi. corticosteroid therapy. Allergy Asthma Clin Immunol 9:30 org/10.1007/s0034 5-018-2324-5. * Nurullah Hamidi dr.nhamidi86@gmail.com Department of Urology, Atatürk Training and Research Hospital, Universiteler Mah, No:1, Cankaya, 06430 Ankara, Turkey Vol.:(0123456789) 1 3

Journal

World Journal of UrologySpringer Journals

Published: Jun 1, 2018

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