A comparative study of efficacy of tamsulosin monotherapy vs. combined (Solifenacin + tamsulosin) in treatment of ureteric stent related symptoms.

Abstract

Ureteric Double J stenting is the most common in endourological practice. The double-J stent, which is the most common form of ureteral stent, is used in obstructive pyelonephritis, intolerable acute renal colic, ureteral edema, ureter perforation following endoscopic procedures. Post stenting commonly reported symptoms include flank pain, haematuria, dysuria, frequency, and urgency. Tamsulosin acts as a selective inhibitor of α1A/1D and Solifenacin acts as a muscarinic receptor antagonist have been used in alleviating the symptoms and have been proved effective. Objective: To study the efficacy of tamsulosin monotherapy vs. combined (solifenacin + tamsulosin) in treatment of ureteric stent related symptoms. Methodology: The prospective control study conducted in R.L. Jalappa Hospital, Tamaka, Kolar. The study included 60 subjects divided on even and odd method with 30 in each group with a period of 3 months. The subjects in group A received oral Tamsulosin of 0.4mg once daily and group B received oral Tamsulosin+ solifenacin (0.4mg+6mg) once daily. The subjects were observed for post-operative complications like flank pain, dysuria and sexual dysfunction. The dysuria was calculated according to Boysarky score and UTI with grading. The data were collected and analysed statistically. Results: The most common age group of presentation of subjects were less than 40 years i.e 22(36.66%) with next common group was 51-60 years accounting 15(25%) with mean age being 45.5 years. The combined therapy group accounted most of the subjects in grade I 23(38.33%) showing significant reduction of post-operative dysuria compared to monotherapy. The combined therapy group had 6 patients with only one patient had grade III UTI. The monotherapy group had 7 subjects developing UTI with grade II being most common. The commonest organism on culture was E. Coli in 9 subjects. There was a significant difference between two groups in reducing UTI. Conclusion: The present study in treatment of DJ stent related symptoms shows combined therapy being more beneficial in terms of reducing post stenting flank pain, dysuria and UTI development in comparison to monotherapy.