Alpha-blockers may improve LUTS, pain after double-J stent insertion

Alpha-blockers have a positive effect on several debilitating symptoms associated with urination in patients receiving double-J stents, according to a study presented by Evangelos Gkougkousis from the Second Department of Urology, Sismanoglio Hospital, University of Athens, here at the AUA annual meeting.

The study, under the direction of lead author Michael Chrisofos, MD, comprised 150 patients (75 men, 75 women) who had unilateral urethral stone-related hydronephrosis, and had opted for conservative treatment with insertion of a double-J ureteral stent. Patients were prospectively randomized into three groups of 50 patients each. The patients in two treatment groups received alfuzosin (Uroxatral), 10 mg, and tamsulosin (Flomax), 0.4 mg, respectively, once a day for 4 weeks. A third group of patients served as the control group and did not receive an alpha-blocker. Four weeks after stent placement, all patients completed a validated ureteral stent symptom questionnaire.

"The whole idea behind this study is that we are trying to show that these symptoms, as well as the morbidity seen after the insertion of double-J stents, are comparable to symptoms of benign prostatic hypertrophy. So that is why we started to use alpha-blockers," said co-author Evangelos Mazaris, MD.

Both alfuzosin and tamsulosin improved the corresponding index in lower urinary tract symptoms (pp=.051). Patients receiving either drug reported a significant (p=.027 and pp=.414) reduction in the incidence of pain and the need for analgesia. The overall pain score favored tamsulosin (p=.035), although alfuzosin had an augmented effect on pain during voiding.

Both alfuzosin and tamsulosin improved the general health index (p