title: Role of α-blockers in the treatment of stent-related symptoms: a prospective randomized control study.
abstract: OBJECTIVE
  To properly use the Ureteric Symptom Score Questionnaire (USSQ) to evaluate, in a randomized control study, the effect of 2 different α-blockers in improving symptoms and quality of life in patients with indwelling ureteral stents.
  
  
  METHODS
  After institutional review board approval, 150 consecutive patients with a double-J ureteral stent inserted after extracorporeal shockwave lithotripsy (ESWL) or ureteroscopic stone treatment were randomly assigned to receive tamsulosin 0.4 mg, alfuzosin 10 mg, or placebo. The validated USSQ was completed 1 and 4 weeks after stent insertion and 4 weeks after stent removal. The Kruskal-Wallis test for independent samples for non-normally distributed ordinal variables, chi-square to compare proportions or differences, and 1-way analysis of variance (ANOVA) for independent samples to compare for differences in case of continuous variables were used for statistical analysis of the results.
  
  
  RESULTS
  Patients receiving α-blockers expressed an overall statistically significant lower urinary (P <.001), pain (P <.001 with stent in situ), and general health index (P <.002) scores. Sexual life and quality of life were also positively influenced. Quality of work was not influenced. No patients had to discontinue medication because of side effects or underwent stent removal before the due date. There was no difference in various outcomes between the 2 α-blockers.
  
  
  CONCLUSIONS
  Stent-related morbidity is a reality in the majority of patients. Simple medication, such as α-blockers, reduce stent-related symptoms and the negative impact on quality of life. It seems that stent-related symptom improvement is independent to the type of α-blocker.
authors.affiliation: Second Department of Surgery, University of Athens, Aretaieion Hospital, Chalandri, Athens, Greece. Electronic address: aedellis@gmail.com.
authors.forename: Athanasios E
authors.initials: AE
authors.lastname: Dellis
authors.affiliation: Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, United Kingdom.
authors.forename: Francis X
authors.initials: FX
authors.lastname: Keeley
authors.affiliation: First Department of Urology, University General Hospital of Athens, Laiko Hospital, Athens, Greece.
authors.forename: Victor
authors.initials: V
authors.lastname: Manolas
authors.affiliation: Second Department of Urology, University of Athens, Sismanoglio Hospital, Northern Athens, Greece.
authors.forename: Andreas A
authors.initials: AA
authors.lastname: Skolarikos
mesh_terms: D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000317:Adrenergic alpha-Antagonists