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Erschienen in: World Journal of Urology 11/2015

01.11.2015 | Original Article

A critical assessment of the effects of tamsulosin and solifenacin as monotherapies and as a combination therapy for the treatment of ureteral stent-related symptoms: a 2 × 2 factorial randomized trial

verfasst von: Jinsung Park, Changhee Yoo, Deok Hyun Han, Dong Wook Shin

Erschienen in: World Journal of Urology | Ausgabe 11/2015

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Abstract

Objective

To assess the efficacy of tamsulosin, solifenacin, and combination therapy of both agents for the treatment of ureteral stent-related symptoms (SRSs).

Methods

An open-label, randomized controlled trial was conducted with 112 patients who underwent unilateral ureteral stent insertion following ureteroscopic stone surgery. Patients were randomized with a 2 × 2 factorial design to one of four groups, i.e., A (control), B (tamsulosin 0.2 mg once daily), C (solifenacin 5 mg once daily), and D (both active treatments). Patients were evaluated at week 2 by the ureteral stent symptom questionnaire (USSQ). The primary efficacy outcome was the urinary symptom score of the USSQ, and the secondary efficacy outcomes were the scores in the other five USSQ domains, the Euro-QOL score, and oral analgesic requirements during the 2 weeks. Efficacy outcomes were primarily analyzed for the per-protocol set population.

Results

The four groups were generally well balanced in terms of baseline characteristics. Eighty-one patients (72.3 %) completed the study protocol. Comparison of the six USSQ domain scores at week 2 showed no differences between the four groups. Similarly, comparison of the domain scores stratified by tamsulosin or solifenacin medication showed no differences for either medication. The other secondary outcomes were also similar in the group comparisons.

Conclusions

Neither tamsulosin nor solifenacin medications provide beneficial effects for relieving various SRSs. In addition, the combination therapy did not have beneficial effects. Further studies are warranted to determine the benefit of medical therapy for the treatment of SRSs and to determine the optimal management strategy for SRSs.
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Literatur
2.
Zurück zum Zitat Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG (2003) Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol 169:1060–1064CrossRefPubMed Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG (2003) Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol 169:1060–1064CrossRefPubMed
3.
Zurück zum Zitat Pollard SG, Macfarlane R (1988) Symptoms arising from double-J ureteral stents. J Urol 139:37–38PubMed Pollard SG, Macfarlane R (1988) Symptoms arising from double-J ureteral stents. J Urol 139:37–38PubMed
4.
Zurück zum Zitat Deliveliotis C, Chrisofos M, Gougousis E, Papatsoris A, Dellis A, Varkarakis IM (2006) Is there a role for alpha1-blockers in treating double-J stent-related symptoms? Urology 67:35–39CrossRefPubMed Deliveliotis C, Chrisofos M, Gougousis E, Papatsoris A, Dellis A, Varkarakis IM (2006) Is there a role for alpha1-blockers in treating double-J stent-related symptoms? Urology 67:35–39CrossRefPubMed
5.
Zurück zum Zitat Beddingfield R, Pedro RN, Hinck B, Kreidberg C, Feia K, Monga M (2009) Alfuzosin to relieve ureteral stent discomfort: a prospective, randomized, placebo controlled study. J Urol 181:170–176CrossRefPubMed Beddingfield R, Pedro RN, Hinck B, Kreidberg C, Feia K, Monga M (2009) Alfuzosin to relieve ureteral stent discomfort: a prospective, randomized, placebo controlled study. J Urol 181:170–176CrossRefPubMed
6.
Zurück zum Zitat Wang CJ, Huang SW, Chang CH (2009) Effects of specific alpha-1A/1D blocker on lower urinary tract symptoms due to double-J stent: a prospectively randomized study. Urol Res 37:147–152CrossRefPubMed Wang CJ, Huang SW, Chang CH (2009) Effects of specific alpha-1A/1D blocker on lower urinary tract symptoms due to double-J stent: a prospectively randomized study. Urol Res 37:147–152CrossRefPubMed
7.
Zurück zum Zitat Park SC, Jung SW, Lee JW, Rim JS (2009) The effects of tolterodine extended release and alfuzosin for the treatment of double-J stent-related symptoms. J Endourol 23:1913–1917CrossRefPubMed Park SC, Jung SW, Lee JW, Rim JS (2009) The effects of tolterodine extended release and alfuzosin for the treatment of double-J stent-related symptoms. J Endourol 23:1913–1917CrossRefPubMed
8.
Zurück zum Zitat Damiano R, Autorino R, De Sio M, Giacobbe A, Palumbo IM, D’Armiento M (2008) Effect of tamsulosin in preventing ureteral stent-related morbidity: a prospective study. J Endourol 22:651–656CrossRefPubMed Damiano R, Autorino R, De Sio M, Giacobbe A, Palumbo IM, D’Armiento M (2008) Effect of tamsulosin in preventing ureteral stent-related morbidity: a prospective study. J Endourol 22:651–656CrossRefPubMed
9.
Zurück zum Zitat Wang CJ, Huang SW, Chang CH (2009) Effects of tamsulosin on lower urinary tract symptoms due to double-J stent: a prospective study. Urol Int 83:66–69CrossRefPubMed Wang CJ, Huang SW, Chang CH (2009) Effects of tamsulosin on lower urinary tract symptoms due to double-J stent: a prospective study. Urol Int 83:66–69CrossRefPubMed
10.
Zurück zum Zitat Navanimitkul N, Lojanapiwat B (2010) Efficacy of tamsulosin 0.4 mg/day in relieving double-J stent-related symptoms: a randomized controlled study. J Int Med Res 38:1436–1441CrossRefPubMed Navanimitkul N, Lojanapiwat B (2010) Efficacy of tamsulosin 0.4 mg/day in relieving double-J stent-related symptoms: a randomized controlled study. J Int Med Res 38:1436–1441CrossRefPubMed
11.
Zurück zum Zitat Mokhtari G, Shakiba M, Ghodsi S, Farzan A, Heidari Nejad S, Esmaeili S (2011) Effect of terazosin on lower urinary tract symptoms and pain due to double-J stent: a double-blind placebo-controlled randomized clinical trial. Urol Int 87:19–22CrossRefPubMed Mokhtari G, Shakiba M, Ghodsi S, Farzan A, Heidari Nejad S, Esmaeili S (2011) Effect of terazosin on lower urinary tract symptoms and pain due to double-J stent: a double-blind placebo-controlled randomized clinical trial. Urol Int 87:19–22CrossRefPubMed
12.
Zurück zum Zitat Lee YJ, Huang KH, Yang HJ, Chang HC, Chen J, Yang TK (2013) Solifenacin improves double-J stent-related symptoms in both genders following uncomplicated ureteroscopic lithotripsy. Urolithiasis 41:247–252CrossRefPubMed Lee YJ, Huang KH, Yang HJ, Chang HC, Chen J, Yang TK (2013) Solifenacin improves double-J stent-related symptoms in both genders following uncomplicated ureteroscopic lithotripsy. Urolithiasis 41:247–252CrossRefPubMed
13.
Zurück zum Zitat Lim KT, Kim YT, Lee TY, Park SY (2011) Effects of tamsulosin, solifenacin, and combination therapy for the treatment of ureteral stent related discomforts. Korean J Urol 52:485–488PubMedCentralCrossRefPubMed Lim KT, Kim YT, Lee TY, Park SY (2011) Effects of tamsulosin, solifenacin, and combination therapy for the treatment of ureteral stent related discomforts. Korean J Urol 52:485–488PubMedCentralCrossRefPubMed
14.
Zurück zum Zitat Shalaby E, Ahmed AF, Maarouf A, Yahia I, Ali M, Ghobish A (2013) 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. Adv Urol 2013:752382PubMedCentralCrossRefPubMed Shalaby E, Ahmed AF, Maarouf A, Yahia I, Ali M, Ghobish A (2013) 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. Adv Urol 2013:752382PubMedCentralCrossRefPubMed
15.
Zurück zum Zitat Lee SJ, Yoo C, Oh CY, Lee YS, Cho ST, Lee SH, Yang DY, Lee SK, Cho JS (2010) Stent Position is more important than alpha-blockers or anticholinergics for stent-related lower urinary tract symptoms after ureteroscopic ureterolithotomy: a prospective randomized study. Korean J Urol 51:636–641PubMedCentralCrossRefPubMed Lee SJ, Yoo C, Oh CY, Lee YS, Cho ST, Lee SH, Yang DY, Lee SK, Cho JS (2010) Stent Position is more important than alpha-blockers or anticholinergics for stent-related lower urinary tract symptoms after ureteroscopic ureterolithotomy: a prospective randomized study. Korean J Urol 51:636–641PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Kuyumcuoglu U, Eryildirim B, Tuncer M, Faydaci G, Tarhan F, Ozgul A (2012) Effectiveness of medical treatment in overcoming the ureteral double-J stent related symptoms. Can Urol Assoc J 6:E234–E237PubMedCentralPubMed Kuyumcuoglu U, Eryildirim B, Tuncer M, Faydaci G, Tarhan F, Ozgul A (2012) Effectiveness of medical treatment in overcoming the ureteral double-J stent related symptoms. Can Urol Assoc J 6:E234–E237PubMedCentralPubMed
17.
Zurück zum Zitat Norris RD, Sur RL, Springhart WP, Marguet CG, Mathias BJ, Pietrow PK, Albala DM, Preminger GM (2008) A prospective, randomized, double-blinded placebo-controlled comparison of extended release oxybutynin versus phenazopyridine for the management of postoperative ureteral stent discomfort. Urology 71:792–795CrossRefPubMed Norris RD, Sur RL, Springhart WP, Marguet CG, Mathias BJ, Pietrow PK, Albala DM, Preminger GM (2008) A prospective, randomized, double-blinded placebo-controlled comparison of extended release oxybutynin versus phenazopyridine for the management of postoperative ureteral stent discomfort. Urology 71:792–795CrossRefPubMed
18.
Zurück zum Zitat Jeon SS, Choi YS, Hong JH (2007) Determination of ideal stent length for endourologic surgery. J Endourol 21:906–910CrossRefPubMed Jeon SS, Choi YS, Hong JH (2007) Determination of ideal stent length for endourologic surgery. J Endourol 21:906–910CrossRefPubMed
19.
Zurück zum Zitat Lee SW, Woo SH, Yoo DS, Park J (2014) Effect of tamsulosin on stone expulsion in proximal ureteral calculi: an open-label randomized controlled trial. Int J Clin Pract 68:216–221CrossRefPubMed Lee SW, Woo SH, Yoo DS, Park J (2014) Effect of tamsulosin on stone expulsion in proximal ureteral calculi: an open-label randomized controlled trial. Int J Clin Pract 68:216–221CrossRefPubMed
20.
Zurück zum Zitat Park J, Shin DW, Chung JH, Lee SW (2013) Shock wave lithotripsy versus ureteroscopy for ureteral calculi: a prospective assessment of patient-reported outcomes. World J Urol 31:1569–1574CrossRefPubMed Park J, Shin DW, Chung JH, Lee SW (2013) Shock wave lithotripsy versus ureteroscopy for ureteral calculi: a prospective assessment of patient-reported outcomes. World J Urol 31:1569–1574CrossRefPubMed
21.
Zurück zum Zitat Park J, Shin DW, You C, Chung KJ, Han DH, Joshi HB, Park HK (2012) Cross-cultural application of the korean version of ureteral stent symptoms questionnaire. J Endourol 26:1518–1522CrossRefPubMed Park J, Shin DW, You C, Chung KJ, Han DH, Joshi HB, Park HK (2012) Cross-cultural application of the korean version of ureteral stent symptoms questionnaire. J Endourol 26:1518–1522CrossRefPubMed
22.
Zurück zum Zitat The EuroQol Group (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16:199–208CrossRef The EuroQol Group (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16:199–208CrossRef
23.
Zurück zum Zitat Beiko DT, Watterson JD, Knudsen BE, Nott L, Pautler SE, Brock GB, Razvi H, Denstedt JD (2004) Double-blind randomized controlled trial assessing the safety and efficacy of intravesical agents for ureteral stent symptoms after extracorporeal shockwave lithotripsy. J Endourol 18:723–730CrossRefPubMed Beiko DT, Watterson JD, Knudsen BE, Nott L, Pautler SE, Brock GB, Razvi H, Denstedt JD (2004) Double-blind randomized controlled trial assessing the safety and efficacy of intravesical agents for ureteral stent symptoms after extracorporeal shockwave lithotripsy. J Endourol 18:723–730CrossRefPubMed
24.
Zurück zum Zitat Yakoubi R, Lemdani M, Monga M, Villers A, Koenig P (2011) Is there a role for alpha-blockers in ureteral stent related symptoms? A systematic review and meta-analysis. J Urol 186:928–934CrossRefPubMed Yakoubi R, Lemdani M, Monga M, Villers A, Koenig P (2011) Is there a role for alpha-blockers in ureteral stent related symptoms? A systematic review and meta-analysis. J Urol 186:928–934CrossRefPubMed
Metadaten
Titel
A critical assessment of the effects of tamsulosin and solifenacin as monotherapies and as a combination therapy for the treatment of ureteral stent-related symptoms: a 2 × 2 factorial randomized trial
verfasst von
Jinsung Park
Changhee Yoo
Deok Hyun Han
Dong Wook Shin
Publikationsdatum
01.11.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 11/2015
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-015-1544-1

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