Prospective Randomized Controlled Study Evaluating Efficacy of Alpha-Blockers, Antimuscarinics or Combination Therapy in Relieving Ureteral Stent-Related Symptoms

Abstract
Background: Double-J ureteral stent placement is a routine urologic procedure after most of urological interventions. Great efforts are being done to decrease stent symptoms including; improving stent materials, physical properties, and design. Also the application of a combination of alpha-blockers and antimuscarinics are used in our study.
Aim of Study: We evaluated the effectiveness and safety of tamsulosin, solifenacin, and combination of both in reducing double-J stent-related lower urinary symptoms.
Patients and Methods: A total of 120 patients with double-J ureteral stenting were randomly divided, post-operatively, into 4 groups. In Group A (n=30), tamsulosin 0.4mg was given, Group B (n=30) received solifenacin 10mg daily, Group C (n=30) received solifenacin 10mg and tamsulosin 0.4mg daily, and Group D (n=30) received placebo (control group). Two weeks after discharge was the first time of evaluation (pre-treatment assessment), using an arabic validated version of USSQ. The second visit was after 4 weeks from surgery just before stent removal (post-treatment assessment).
Results: There were statistical significance in urinary symptoms, pain, general health and work performance scores in favour of Group III as compared to the tamsulosin group, the solifenacin group, and the control group (p-value <0.001).
Conclusion: Combined therapy of tamsulosin and solif-enacin significantly alleviated symptoms associated with double-J stents as compared to either medication alone.