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.

TRIAL REGISTRATION:

The study protocol was registered on Chinese Clinical Trial Register on April 17th, 2013 (registration number: ChiCTR-TRC-13003148 ).

• Authors: Qinyu Liu, Banghua Liao, Ruochen Zhang, Tao Jin, Liang Zhou, Deyi Luo, Jiaming Liu, Hong Li, Kunjie Wang
• Journal: BMC urology (BMC Urol) Vol. 16 Issue 1 Pg. 66 (Nov 15 2016) ISSN: 1471-2490 [Electronic] England
• PMID: 27846839 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Adrenergic alpha-1 Receptor Antagonists
• Muscarinic Antagonists
• Sulfonamides
• Tamsulosin
• Solifenacin Succinate

Topics

• Adrenergic alpha-1 Receptor Antagonists (administration & dosage)
• Adult
• Combined Modality Therapy
• Drug Therapy, Combination
• Female
• Humans
• Male
• Muscarinic Antagonists (administration & dosage)
• Postoperative Complications (drug therapy, etiology)
• Solifenacin Succinate (administration & dosage)
• Stents (adverse effects)
• Sulfonamides (administration & dosage)
• Tamsulosin
• Time Factors
• Treatment Outcome
• Ureteral Diseases (drug therapy, etiology)