Efficacy of Tamsulosin, Oxybutynin, and their combination in the control of double-j stent-related lower urinary tract symptoms.
OBJECTIVE
Indwelling double J ureteral stents are used routinely in the resolution of ureteral obstruction caused by different etiologies. Evaluation of urinary symptoms related to double-J stent, indicate that these affect 73-90% of patients. We conducted a prospective, randomized study, to evaluate the efficacy of tamsulosin, oxybutinin and combination therapy in improving the urinary symptoms.


METHODS
Patients who underwent ureteral stent placement after ureterolithotripsy (total 51), were randomized into three groups: Group I: Tamsulosin 0.4 mg. Once per day(17 patients), Group II: Oxybutinin 5 mg. once per day (17 patients), Group III: Tamsulosin+ oxybutynin once per day (17 patients). All the groups received the drugs for three weeks and completed a Spanish validated Ureteral Stent Symptom Questionnaire (USSQ) at day 7 and 21.


RESULTS
Repeated measures ANOVA showed mean urinary symptom index score was 22.3 vs. 15.5 in group three (p<0.001) at day 7 and 21 respectively. The mean work performance index was 6.6 vs 8.1 (p=0.049) favoring tamsulosin group, the mean sexual score was 0.5 vs 1.5 (p=0.03). Among additional problems the mean was 7.2 vs 6.2 (p=0.03). No significant difference was noted among pain and general health index. No side effects were reported.


CONCLUSIONS
Combination therapy with tamsulosin and oxybutynin improved irritative symptoms and work performance as well as sexual matters. Combination therapy should be considered for patients who complained of stent related symptoms.
Departamento de Urologia, Hospital Geral de Mexico, Ciudad de Mexico.
Miguel
M
Maldonado-Avila
Departamento de Urologia, Hospital Geral de Mexico, Ciudad de Mexico.
Leopoldo
L
Garduno-Arteaga
Departamento de Urologia, Hospital Geral de Mexico, Ciudad de Mexico.
Rene
R
Jungfermann-Guzman
Departamento de Urologia, Hospital Geral de Mexico, Ciudad de Mexico.
Hugo A
HA
Manzanilla-Garcia
Departamento de Urologia, Hospital Geral de Mexico, Ciudad de Mexico.
Emmanuel
E
Rosas-Nava
Departamento de Urologia, Hospital Geral de Mexico, Ciudad de Mexico.
Nestor
N
Procuna-Hernandez
Departamento de Urologia, Hospital Geral de Mexico, Ciudad de Mexico.
Alejandro
A
Vela-Mollinedo
Departamento de Urologia, Hospital Geral de Mexico, Ciudad de Mexico.
Luis
L
Almazan-Trevino
Instituto Mexicano del Seguro Social Colima, no México.
Jose
J
Guzman-Esquivel
D000328:Adult; D000704:Analysis of Variance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D008333:Mandelic Acids / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D016037:Single-Blind Method; D015607:Stents / Q000009:adverse effects*; D013449:Sulfonamides / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D000077409:Tamsulosin; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter; D014517:Ureteral Obstruction / Q000150:complications / Q000628:therapy; D018666:Ureteroscopy; D064804:Urological Agents / Q000627:therapeutic use*
D008333:Mandelic Acids; D013449:Sulfonamides; D064804:Urological Agents; D000077409:Tamsulosin; C005419:oxybutynin