Randomized Controlled Trial to Compare the Safety and Efficacy of Tamsulosin, Solifenacin, and Combination of Both in Treatment of Double-J Stent-Related Lower Urinary Symptoms

Abstract

Purpose. We evaluated the effectiveness and safety of tamsulosin, solifenacin, and combination of both in reducing double-J stent-related lower urinary symptoms. Materials and Methods. A total of 338 patients with double-J ureteral stenting were randomly divided, postoperatively, into 4 groups. In group I (n = 84), no treatment was given (control group), group II (n = 85) received tamsulosin 0.4 mg daily, group III (n = 84) received solifenacin 10 mg daily, and group IV (n = 85) received a combination of both medications. Before insertion and 2 weeks after, all patients completed the International Prostate Symptom Score (IPSS), quality of life component of the IPSS (IPSS/Qol), Overactive Bladder Questionnaire (OAB-q), and Visual Analogue Pain Scale (VAPS) questionnaire. Results. The demographics and preoperative questionnaires scores of all groups were comparable. There were statistically significant differences in all scores in favour of groups II, III, and IV as compared to control group (P value < 0.005). Group IV showed statistically significant differences in total IPSS, QoL score, and OAB-q score as compared to groups II and III (P value < 0.001). Conclusions. Combined therapy of tamsulosin and solifenacin significantly alleviated lower urinary symptoms associated with double-J stents as compared to either medication alone.

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

“…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.…”

“…Joshi et al (5) developed the Ureteral Stent Symptom Questionnaire (USSQ) in order to evaluate the symptoms and impact on the quality of life of patients following ureteral stents, which included 38 scoring items over six sections, covering: Urinary symptoms, pain, general health, work performance, and sexual matters with additional problems. Additional methods, including the Visual Analog Pain Scale (VAPS), International Prostate Symptom Score (IPSS) and the Short-form 36 Health Survey Scale (SF-36) α 1 -blockers for the reduction of ureteric stent-related symptoms: A systematic review and meta-analysis have been applied to evaluate USS in relevant studies (14,15). Previous studies have demonstrated that α 1 -blockers have a significant impact on patients with USS (13,16).…”