Effects of Tamsulosin and Tolterodine on double J stent–related symptoms: A double-blind, randomized, placebo-controlled trial

Abstract

Background:Ureteral double J stent are routinely applied for urologic patients although stent-related symptoms are common. Several attempts have been reported to minimize these symptoms.Objective:To compare Tolterodine, Tamsulosin, and placebo effects on double J stent–related symptoms.Material and method:In all, 125 patients (82 males and 43 females) with double J stent were randomly divided into three groups (group 1, n: 42, group2, n: 40 and group 3, n: 43). Each patient randomly received one pack of drug in different colors by a nurse unaware of the content to take Tamsulosin 0.4 mg before sleep (MODALUSINE), Tolterodine 2 mg twice a day or placebo once daily (capsules filled with starch): group 1 received placebo, group 2 Tamsulosin and group 3 Tolterodine for 1 month in a double-blind manner. Ureteral stent-related morbidity indices which analyzed include urinary symptom, pain, general health, quality of work and sex scores. All of indices measured by Ureteral Symptom Score Questionnaire for first and fourth weeks after drug consumption and the first week after double J stent removal (labeled as w1, w4, and w5, respectively).Result:The mean age was 44.8 years (range: 15–83 years). There was no statistically significant difference in background characteristics between groups (p value > 0.05). The most important and statistically significant results were Tolterodine-reduced urinary symptom score (p value = 0.001) and improved general health score (p value = 0.007) of the fourth week. The pain score in groups of Tamsulosin and Tolterodine significantly reduced between weeks 4 and 1 and 5 and 1 (both with the p value < 0.05), but in other indices, there was no significant difference between them.Conclusion:According to our results, we suggest Tolterodine to minimize stent-related urinary symptom and improve general health in patients with double J stent.

Comparison of safety and efficacy of silodosin, solifenacin, tadalafil and their combinations in the treatment of double-J stent- related lower urinary system symptoms: A prospective randomized trial

“…Numerous drugs had been tried to relieve these symptoms like alpha blockers, anticholinergics, phosphodiesterase inhibitors (PDE5Is) and analgesics. [6,7,[13][14][15][16][17][18][19][20][21][22][23][24][25][26] Silodosin is a highly selective alpha-1 adrenergic receptor antagonist which is used in the treatment of lower urinary tract symptoms (LUTS). Alpha-1 adrenergic receptors are densely found in the smooth muscle cells of the lower urinary tract, and silodosin relaxes them and improves the SRS, and various studies had also shown similar effect.…”

“…[13][14][15][16][17][18][19][20][21] Anticholinergics can also improve SRS by reducing the involuntary bladder contraction that occurs due to trigone irritation. [18][19][20][21][22][23][24][25] PDE5Is increase levels of cGMP that will lead to relaxation of the smooth muscle of ureter and reduces SRS. [6,26] The aim of our study was to evaluate the efficacy and safety of silodosin, solifenacin, tadalafil, and their combinations in reducing DJ stent-related LUTS.…”

“…Alpha-blockers, anticholinergics and their combinations can be used for the management of SRSs with good results. [13][14][15][16][17][18][19][20][21][22][23][24][25][26]30] Recently some studies have also shown the role of PDE5Is in SRS. [6,26] But most of these studies haven't used the most validated score (USSQ) with QOL score for the assessment of SRSs.…”

“…Anticholinergics alone and in combination with alpha-blockers have been found to be effective in patients with SRS but combination therapy is more effective than monotherapy. [18][19][20][21][22][23][24][25]30] PDE-5 inhibitors are FDA approved drugs for erectile dysfunction, LUTS due to prostatic hyperplasia, and…”

Effect of highly concentrated hyaluronic acid/chondroitin sulphate instillation on ureteric stent‐induced discomfort after ureteroscopic lithotripsy: a multicentre randomised controlled pilot study

“…They found that the bladder mucosa normalised after the instillation. Table 4 provides a summary of existing studies about this issue, and most of the studies used the USSQ to measure the clinical discomfort caused by ureteric stenting [31][32][33][34][35][36][37][38][39][40][41]. As shown in Table 3, current existing evidence supports the specific treatment strategy to control discomfort due to ureteric stent indwelling either by a-blockers or other treatments.…”