title: Combination therapy only shows short-term superiority over monotherapy on ureteral stent-related symptoms - outcome from a randomized controlled trial.
abstract: BACKGROUND
  Controversy remains on the superiority of combination therapy over monotherapy on ureteral stent-related symptoms (SRSs). We tend to explore if there is a necessity of combination therapy.
  
  
  METHODS
  One hundred cases of unilateral upper urinary tract calculi with stent insertion (pre and post flexible ureteroscopy) were randomized into 4 groups, given non-treatment, solifenacin, tamsulosin or combination respectively. Eight times of follow-ups were given after each insertion.
  
  
  RESULTS
  SRSs released spontaneously within 4 days after insertion (p = 0.017) but then stay with no further improvement. Benefit of solifenacin on flank pain started showing after day4 (p = 0.002), which was comparable to that of tamsulosin and combination (p = 0.914 vs 0.195). Combination therapy showed superiority over both monotherapy before day4, but after then solifenacin and tamsulosin showed similar effectiveness with the combination therapy on both bladder pain (p = 0.229 vs 0.394) and urgency (p = 0.813 vs 0.974). No improvement on hematuria or frequency was observed in each group.
  
  
  CONCLUSIONS
  Combination therapy takes effect faster but shows no supervisory after the first few days compared with monotherapy.
  
  
  BACKGROUND
  The study protocol was registered on Chinese Clinical Trial Register on April 17th, 2013 (registration number: ChiCTR-TRC-13003148 ).
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Qinyu
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Banghua
authors.initials: B
authors.lastname: Liao
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Ruochen
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Jin
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Deyi
authors.initials: D
authors.lastname: Luo
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Jiaming
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China. wangkj@scu.edu.cn.
authors.forename: Kunjie
authors.initials: K
authors.lastname: Wang
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage*; D000328:Adult; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology*; D000069464:Solifenacin Succinate / Q000008:administration & dosage*; D015607:Stents / Q000009:adverse effects*; D013449:Sulfonamides / Q000008:administration & dosage*; D000077409:Tamsulosin; D013997:Time Factors; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D018727:Muscarinic Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin; D000069464:Solifenacin Succinate
keywords: Adrenergic alpha-1 receptor antagonists; Medication therapy management; Muscarinic antagonists; Stent-related symptoms