"We unfortunately did not find any difference in pain scores [after ureteroscopy] at day 1, 2, or 3. We also didn't find any difference in use of rescue medication and rescue narcotic medication," says Karen L. Stern, MD.
In this video, Karen L. Stern, MD, discusses the background, findings, and potential future research from the study, “Effect of cannabidiol oil on post-ureteroscopy pain for urinary calculi: A randomized, double-blind, placebo-controlled trial.” Stern is a practicing endourologist at Mayo Clinic in Phoenix, Arizona.
As urologists, we have a lot of issues with controlling pain and discomfort after ureteroscopy specifically, stent discomfort. There's been this huge movement over the last several years to move away from narcotics, given the increased risk of abuse and addiction. So, we decided to see what else we could use. I've had, anecdotally, a few patients who have said they use THC or CBD and it's really helped with stone pain. There is some evidence that CBD has been helpful in other urologic disorders like bladder spasms, neurogenic bladder. So, we decided to look into this. There is only 1 FDA approved CBD. It does not include THC. It's called Epidiolex. And it's actually an FDA-approved seizure medication for children. In this study, we decided to look at Epidiolex for post ureteroscopy pain.
We did a double-blind, placebo-controlled trial. We enrolled 90 patients. What was not surprising, but was pleasant is we had 0 issues with patient recruitment. Patients were really willing to try this and were very interested in it. We unfortunately did not find any difference in pain scores at day 1, 2, or 3. We also didn't find any difference in use of rescue medication and rescue narcotic medication. However, there are some issues why we think that may be the finding, and so we would love to look at this more.
A couple of our limitations, 1, we used a really low dose, because this has never been looked at before in this indication. We used actually a dose that's more for children. We did prove that it's safe and well-tolerated, so we would love to do the trial over with a higher dose. In addition, if we could find a formulation that perhaps has THC with it, there may be a better efficacy. We'd love to look into that as well.