Effects of specific α-1A/1D blocker on lower urinary tract symptoms due to double-J stent: a prospectively randomized study

Abstract

The aim of our study was to evaluate the effect of tamsulosin in improving symptoms in patients with indwelling double-J ureteral stents. This prospective study lasted from April 2006 to March 2008. All the patients with symptomatic lower ureteral stones with <15 mm diameter were enrolled, and were prospectively randomized (random numbers table) into two groups. A total of 154 patients, with insertion of a double-J ureteral stent after ureteroscopic stone removal. In group 1, 75 patients were enrolled and received placebo for 2 weeks. Group 2 included 79 patients who received 0.4 mg of tamsulosin, once daily for 2 weeks. All patients completed the validated ureteral stent symptom questionnaire (USSQ) and quality of life of international prostate symptom scale (IPSS) for evaluating the symptoms of double-J stents and quality of life after double-J stent insertion and removal, respectively. The analysis of the questionnaire at W1 revealed a significant difference in the main score index of urinary symptoms, body pain and general health between groups 1 and 2. When comparing W1 evaluation with that of W4 after double-J removal, both groups showed significant worsening of urinary symptoms, body pain, general health and work performance, except sexual performance. The mean score of quality of life in IPSS was 4.21 in group 1 and 1.6 in group 2. Tamsulosin can improve a subset of stent-related urinary symptoms and quality of life effectively and may be applied in routine clinical practice.

α1-blockers for the reduction of ureteric stent-related symptoms: A systematic review and meta-analysis

“…In terms of the results of statistical analysis, significant differences in IPSS voiding symptom sub-scores (MD, -2.66; 95% CI, -4.36 to -0.96) were detected; however, no significant differences in IPSS storage symptom sub-scores (MD, -0.93; 95% CI, -2.28 to 0.43) were detected (Table IV). The pooled USSQ urinary symptoms score data (MD, -5.84; 95% CI, -9.35 to-2.33) for seven studies (13,16,(22)(23)(24)(25)30) demonstrated that α 1 -blockers administration significantly reduced USS.…”

“…A Russian article published in Urologiia met the inclusion criteria according to the English abstract in PubMed; however it was subsequently excluded, since the full text could not be located (21). A total of 14 RCTs including 1,075 patients were included in the present meta-analysis (13,15,16,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

“…Table I outlines the characteristics of each study included in the present meta-analysis. All included studies were RCTs; eight studies were performed in Asia, (24)(25)(26)(27)(28)31,32) three in Europe (13,16,22), two in Africa (15,29), and one in America (23). Participant ages ranged from 17-87 and the follow up periods were 1-6 weeks.…”

“…sub-scores, five trials (15,26,27,29,32) employed voiding symptoms sub-scores, and seven trials (13,16,(22)(23)(24)(25)30) evaluated USSQ urinary symptoms scores in order to evaluate the effectiveness of α 1 -adrenoceptor antagonists as therapeutic agents for patients with USS. VAPS was adopted in nine studies (13,15,16,23,25,26,28,30,32) and USSQ pain score was applied in six trials (13,16,(22)(23)(24)(25) In eight studies, analgesics and/or antibiotics were used in all patients as a general therapy.…”

“…VAPS was adopted in nine studies (13,15,16,23,25,26,28,30,32) and USSQ pain score was applied in six trials (13,16,(22)(23)(24)(25) In eight studies, analgesics and/or antibiotics were used in all patients as a general therapy. No significant differences in the rates of employment and sexual activity were demonstrated between the treatment groups.…”