Seventy five patients were evenly and randomly distributed into 1 of three arms – alpha blocker administration (tamsulosin OCAS, alfuzosin 10mg or silodosin 8mg), beta 3 agonist (mirabegron 50mg), or placebo. Medication administration began 2 days after stent placement and ended 4 weeks after placement. USSQ scores at 1 and 4 weeks after stent placement, and 4 weeks after stent removal were compared between arms. Patients in the alpha-blocker and beta agonist arms experienced significantly lower overall scores in the domains of urinary symptoms (p < .001), pain (p < .001), and general health (p < .001). The two medication arms also had lower scores for sexual health, quality of life, and work performance but these differences did not reach significance. Alpha blockers proved to be more efficacious than beta 3 agonists in the domains of urinary symptoms (p = .05) and pain (p = .03), and 2 patients on beta 3 agonist therapy had to discontinue treatment due hypertension dysregulation. No other side effects or adverse events were reported.
The authors of this study show that treatment with either alpha blockers or beta 3 agonists decreases stent related morbidity over placebo, and alpha blockers seem to be slightly better for this purpose. The study is still ongoing, and Tsirkas et al. hope to test whether or not combination therapy with these two drug classes can further improve these symptoms than either alone.
Presented by: Kimon Tsirkas, MD, Department of Urology, General Hospital of Athens G.N.A. “G. Gennimatas”, Athens, Greece
Authors: Athanasios Dellis, Athanasios Papatsoris, Konstantinos Spyropoulos, Konstantinos Nastos, Charalambos Deliveliotis, Andreas Skolarikos
Written By: Max Towe at the 36th World Congress of Endourology (WCE) and SWL - September 20-23, 2018 Paris, France