Objective: The main objective of this study was to evaluate the efficacy of tamsulosin or mirabegron on ureteral stent-related symptoms. Patients and methods: This was a prospective, randomized, controlled, and singleblinded study. In total, 180 patients who had undergone ureterolithotripsy and ureteral stent insertion were included. Patients were randomly divided into three groups as follows: Group 1 was the control group taking placebo; group 2 was administered tamsulosin (0.4 mg) once a day; and group 3 received mirabegron (50 mg) once a day. The Turkish version of the ureteral stent symptom questionnaire was filled out after 4 weeks. Results: After excluding patients who were lost to follow-up, 161 patients were included in the final analysis. Analgesic usage doses were lower in the tamsulosin (5.1 ± 1.8) and mirabegron (4.5 ± 1.4) groups than in the control group (5.9 ± 2.1; P < .001). The urinary symptoms score was lower in tamsulosin group than it was in the control group (22.1 vs 27.8; P = .001); however, the other scores (body pain, general health, work performance, sexual matters, and other problems) were similar between the groups. Conclusions: Tamsulosin improves only urinary symptoms due to the ureteral stent and decreases the need for analgesics. Mirabegron has no effect on ureteral stentrelated symptoms, but it decreases analgesic need. K E Y W O R D S lower urinary tract symptoms, mirabegron, tamsulosin, ureteral stent 1 | INTRODUCTION Ureteral stents (USs) are widely used in urology practice to resolve obstruction, to help recovery of ureteric injury, or are routinely inserted after surgery. 1 However, about 80% of patients experience stent-related pain, and more than half of them have lower urinary tract symptoms (LUTSs; frequency, urgency, dysuria, and incomplete emptying). 2-4 For these patients, their working capacity decreases and sexual health deteriorates; thus, their quality of life is adversely affected due to pain and urinary symptoms. 5 Two main mechanisms are blamed for causing all these disorders: The first is high pressure transmitted to the renal pelvis during urination from the bladder by reflux; the second is a distal ureter (even whole ureter) and bladder spasms due to irritation from the US. 6,7 Tamsulosin is a selective inhibitor of alpha-1a (minimal 1d) adrenergic contraction; alpha-1a is present in the smooth muscles of the distal ureter, trigone, and bladder neck. 8 Tamsulosin has also long been used for pain and US-related symptoms. 9-12 Mirabegron is a beta-3 adrenergic receptor agonist that is currently available for treatment of overactive bladder symptoms. 13 Beta-3 adrenergic receptors
