Efficacy and safety of tamsulosin oral-controlled absorption system, solifenacin, and combined therapy for the management of ureteric stent-related symptoms

Ashraf M Abdelaal; Ahmed M Al-Adl; Shabieb A Abdelbaki; Mohamed M Al Azab; Khaled A Al Gamal

doi:10.1016/j.aju.2016.01.004

Efficacy and safety of tamsulosin oral-controlled absorption system, solifenacin, and combined therapy for the management of ureteric stent-related symptoms

Arab J Urol. 2016 Feb 22;14(2):115-22. doi: 10.1016/j.aju.2016.01.004. eCollection 2016 Jun.

Authors

Ashraf M Abdelaal¹, Ahmed M Al-Adl², Shabieb A Abdelbaki¹, Mohamed M Al Azab³, Khaled A Al Gamal¹

Affiliations

¹ Department of Urology, Benha University, Benha, Egypt.
² Department of Urology, Benha University, Benha, Egypt; Al Adwani General Hospital, Taif, Saudi Arabia.
³ Department of Urology, Benha University, Benha, Egypt; International Medical Center, Jeddah, Saudi Arabia.

Abstract

Objectives: To evaluate the efficacy of solifenacin, tamsulosin oral-controlled absorption system (OCAS), and the combination of both drugs on JJ stent-related symptoms using the validated Arabic version of the ureteric stent symptom questionnaire (USSQ).

Patients and methods: In all, 260 patients who had undergone JJ stenting of the ureter for different endoscopic urological procedures were postoperatively randomly assigned into four equal groups. Patients in Group I received no treatment and served as the control group, Group II patients received tamsulosin OCAS 0.4 mg daily, Group III patients received solifenacin 5 mg daily, and Group IV patients received a combination of both drugs. Before stent removal, all patients completed the Arabic version of the USSQ.

Results: In all, 234 patients completed the study, comprised of 56 in Group I, 59 in Group II, 58 in Group III, and 61 in Group IV. Baseline characteristics and indications for JJ stenting were comparable in the four groups. There were highly significant differences in all items of the USSQ between the treatment groups and the controls, while Group II and III were comparable. The USSQ score was significantly lower in Group IV vs Groups II and III. Crossing of the distal curl of the stent to the midline had a significant positive correlation with the severity of the urinary symptoms, body pain, general health, and work performance in the medicated groups.

Conclusions: Combined therapy with tamsulosin OCAS 0.4 mg daily and solifenacin 5 mg daily is a safe and well-tolerated management for stent-related symptoms. However, stent position remains a significant factor affecting response to medical therapy and patients' health-related quality of life.

Keywords: ESWL, extracorporeal shock wave lithotripsy; OAB, overactive bladder; OCAS; PCNL, percutaneous nephrolithotripsy; QoL, quality of life; RCT, randomised controlled trial; Solifenacin; Tamsulosin; URSL, ureteroscopic lithotripsy; USSQ, ureteric stent symptoms questionnaire; Ureteric stent-related symptoms; VAPS, visual analogue pain scale.