Does Combination Therapy with @entity9940 and @entity2181 Improve Ureteral Stent Discomfort Compared with XXXX Alone? A Double-Blind, Randomized, Controlled Trial.

@entity1 @entity2181 @entity1790 @entity158 @entity9940
PURPOSE: Ureteral stent discomfort is a significant postoperative problem for  many @entity1 . Despite the use of narcotics and a-blockers @entity1 often experience bothersome lower urinary tract symptoms and @entity158 , which impair daily activities. We compared combination therapy with an a-blocker and an anticholinergic to monotherapy with an a-blocker. MATERIALS AND METHODS: A double-blind, randomized, controlled trial was performed from December 2012 to April 2014. A total of 80 @entity1 were randomized, including 44 to the combination group ( @entity9940 0.4 mg and @entity2181 early release 4 mg) and 36 to the monotherapy group ( @entity9940 0.4 mg and placebo). @entity1 with preexisting ureteral stent placement or current anticholinergic therapy were excluded from study. @entity1 completed USSQ (Urinary Stent Symptom Questionnaire) before stent placement on the day of surgery, the day after stent placement, the morning of stent removal and the day after stent removal. The questionnaire included questions regarding urinary symptoms, general health, @entity158 , and work and sexual history. RESULTS: A total of 80 @entity1 (40 males and 40 females) were studied. Mean age was 51.5 vs 51.3 years (p = 0.95) and mean body mass index was 33.6 vs 31.9  kg/m(2) (p = 0.44) in monotherapy group 1 vs combination therapy group 2. Between  the 2 groups there was no significant difference in urinary symptoms, @entity158 and activities of daily living from baseline to just before stent removal (p = 0.95, 0.40 and 0.95, respectively). Although there was no difference between the groups, both showed improvement in urinary symptoms from the time of  initial stent insertion to just prior to stent removal (difference -0.50 for combination therapy and -0.40 for monotherapy). The mean stent indwelling time of 9.6 and 8.7 days in the combination and monotherapy groups, respectively, did not differ (p = 0.67). On ANOVA it had no significant impact on results (p = 0.64). CONCLUSIONS: Combination therapy with @entity9940 and @entity2181 does not appear to improve urinary symptoms, bodily @entity158 or quality of life in @entity1 after ureteral stent placement for @entity1790 compared to @entity9940 alone. Both groups experienced worse urinary symptoms, @entity158 and quality of life with a stent, suggesting that further research is necessary to improve stent discomfort.
