Supplementary Files
Keywords
How to Cite
Abstract
Introduction: Currently, tamsulosin 0.4 mg daily is the dosage indicated for lower urinary tract symptoms for patients with an indwelling stent. In treating benign prostatic hyperplasia, a total maximum dose of 0.8 mg tamsulosin is used (either 0.4 mg twice daily or 0.8 mg daily), which has shown increased efficacy compared to the 0.4mg daily dose without an increase in adverse effects
Objective: Our goal was to compare two different dosing regimens (0.4 mg daily vs. 0.4 mg twice per day) of tamsulosin for ureteral stent-related discomfort.
Methodology: A prospective comparative study was conducted in Kathmandu Medical College and Teaching Hospital, Kathmandu among 60 patients who had unilateral ureteral stent placed. Patient who have undergone DJ stenting on the odd days of the calendar were advised to take once a day 0.4 mg tamsulosin, and the patients undergoing stenting on the even days of the calendar were advised to take twice a day 0.4 mg tamsulosin who had developed lower urinary tract symptoms (LUTS), with USSQ Score >10 on seventh post-operative day. Both the groups were asked to fill Ureteral Stent Symptom Questionnaire (USSQ) after informed consent at four weeks before stent removal to assess mean change in USSQ score.
Result: It was observed that mean USSQ score was 38.36±16.07 (Range: 12-77) in once a day tamsulosin group whereas mean USSQ score was 14.87 ± 8.62 (Range: 3-32) in twice a day tamsulosin group. The USSQ score significantly reduced in patients taking 0.8 mg tamsulosin. (p=0.001). The incidence of adverse events like headache, abnormal ejaculation, and orthostatic hypotension was more frequent with tamsulosin 0.8 mg but not significant. Only dizziness was significantly more frequent in twice a day tamsulosin group. (p <0.001).
Conclusion: The administration of twice a day tamsulosin improves stent-related urinary symptoms as compared to once daily dosage without much increment in side effects.
References
Venkatesan N, Shroff S, Jayachandran K, Doble M. Polymers as ureteral stents. J Endourol. 2010; 24: 191-198. [PubMed | Full Text | DOI]
Dunn CJ, Matheson A, Faulds DM. Tamsulosin: a review of its pharmacology and therapeutic efficacy in the management of lower urinary tract symptoms. Drugs Aging. 2002;19(2):135-61. [PubMed | Full Text | DOI]
Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol. 2003 Mar;169(3):1060-4. [PubMed | Full Text | DOI]
Mirani KK, Ather MH. Translation and Validation of the Ureteral Stent Symptoms Questionnaire in Urdu. Cureus. 2022 Aug 8;14(8):e27764. [PubMed | Full Text | DOI]
Narayan P, Tewari A. A second phase III multicenter placebo controlled study of 2 dosages of modified release tamsulosin in patients with symptoms of benign prostatic hyperplasia. United States 93-01 Study Group. J Urol. 1998 Nov;160(5):1701-6. [PubMed | Full Text | DOI]
Navanimitkul N, Lojanapiwat B. Efficacy of tamsulosin 0.4 mg/day in relieving double-J stent-related symptoms: a randomized controlled study. J Int Med Res. 2010 Jul-Aug;38(4):1436-41. [PubMed | Full Text | DOI]
Liu Y, Chen Y, Liao B, Luo D, Wang K, Li H, Zeng G. Epidemiology of urolithiasis in Asia. Asian J Urol. 2018 Oct;5(4):205-214.[PubMed | Full Text | DOI]
Van der Meer RW, Weltings S, van Erkel AR, Roshani H, Elzevier HW, van Dijk LC, et al. Antegrade ureteral stenting is a good alternative for the retrograde approach. Curr Urol 2016; 10(2): 87-91. [PubMed | Full Text | DOI]
Ahallal Y, Khallouk A, El Fassi MJ, Farih MH. Risk factor analysis and management of ureteral double-j stent complications. Rev Urol 2010; 12(2-3): e147-151. [PubMed | Full Text | DOI]
Paul CJ, Brooks NA, Ghareeb GM, Tracy CR. Pilot study to determine optimal stent duration following ureteroscopy: three versus seven days. Curr Urol 2017; 11(2): 97-102. [PubMed | Full Text | DOI]
Damiano R, Autorino R, De Sio M, Giacobbe A, Palumbo IM, D'Armiento M. et al. Effect of tamsulosin in preventing ureteral stent-related morbidity: a prospective study. J Endourol 2008; 22(4): 651-656. [PubMed | Full Text | DOI]
Lamb AD, Vowler SL, Johnston R, Dunn N, Wiseman OJ. Metaanalysis showing the beneficial effect of ?-blockers on ureteric stent discomfort. BJU Int 2011; 108(11): 1894-902. [PubMed | Full Text | DOI]
Yakoubi R, Lemdani M, Monga M, Villers A, Koenig P. Is there a role for ?-blockers in ureteral stent related symptoms? A systematic review and meta-analysis. J Urol 2011; 186(3): 928- 934. [PubMed | Full Text | DOI]
Osman T, Elawady H, Fawaz K, Shabayek M, Essam MD, Osman D, ElSaeed KO. Evaluation of Tamsulosin 0.4 mg versus 0.8 mg in management of lower urinary tract symptoms due to benign prostatic enlargement. Int Urol Nephrol. 2024 Jun;56(6):1811-1816. [PubMed | Full Text | DOI]