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To compare the efficacy of tamsulosin and tolterodine in double-J stent-related symptoms: A prospective randomized trial

Background: Stent-related symptoms affect nearly 80% of patients with indwelling ureteral stents. Alpha blockers relieve flank pain by blocking alpha-adrenergic receptors and relaxing the smooth muscles of ureter, trigone, and prostatic urethra, thus reducing bladder outlet resistance and voiding pressure, whereas mechanism of anticholinergic drugs involves relief of involuntary bladder contractions that are mediated by muscarinic receptors. We have compared alpha blocker and anticholinergic drugs in reducing stent discomfort. Materials and Methods: The study was conducted from March 2017 to February 2018. A total of 100 patients with unilateral double-J ureteral stenting were randomized, postoperatively into two groups: tamsulosin 0.4mg daily (Group I) and tolterodine 4mg daily (Group II). Results: The mean age was 39.1 years in Group I and 38.0 years in Group II. The male:female ratio in Group I and Group II was 1.38:1 and 1:1, respectively. There was statistically significant difference in urinary symptom score, pain score, and general health score between the two groups in favor of Group I (tamsulosin 0.4mg) at 1week post-stenting and 4 weeks (at stent removal). Conclusion: Oral medication, with uroselective alpha blockers, in patients with indwelling stents reduces stent-related symptoms and negative impact on quality of life.