Efficacy of combination therapy tadalafil plus tamsulosin in ureteral stents-related symptoms relief

• Published in: Central European journal of urology 2024-01, Vol.77 (1), p.111-116
• Main Authors: Komisarenko, Ihor, Banyra, Oleg, Nikitin, Oleg, Klymenko, Yaroslav, Chaplia, Mykola, Borzhievskyy, Andrii
• Format: Article
• Language: English
• Subjects: Analgesics; Lithotripsy; Nonsteroidal anti-inflammatory drugs; Normal distribution; Original Paper; Patients; Performance evaluation; Quality of life; Questionnaires; Sodium; Software; Stents; Urogenital system
• ISSN: 2080-4806; 2080-4873; 2080-4873
• DOI: 10.5173/ceju.2023.66

Ureteral stents-related symptoms (USRs) are the common complications of ureteral stenting. Tamsulosin a selective alpha-1 blocker and Tadalafil a PDE-5 inhibitor are one of drugs have been used for USRs relief. In this study we aimed to evaluate the effectiveness and safety of combination therapy Tamsulosin+Tadalafil for treating USRs comparing it with the efficacy of either Tamsulosin or Tadalafil monotherapies. 279 patients with indwelled unilateral ureteral stents were randomized to Tamsulosin 0.4 mg + Tadalafil 5 mg once a day (Group 1, n = 67), Tamsulosin 0.4 mg once a day (Group 2, n = 71), Tadalafil 5 mg once a day (Group 3, n = 69) and Placebo once a day (Group 4, n = 72). USRs severity was registered and calculated by using the Ureteral Symptoms Score Questionnaire (USSQ) at the 14 day of treatment. Side-effects and total analgesic use were recorded and compared. At the endpoint in patients with unilateral ureteral stents the combination therapy Tamsulosin + Tadalafil led to statistically lower intensity of urinary symptoms comparing with Tamsulosin (15.2 ±4.3 vs 21.8±3.6, p = 0.0003) or Tadalafil (15.2 ±4.3 vs 20.6 ±2.8, p = 0.0004) monotherapy. All groups of treatment demonstrated significant relief of USRs comparing with Placebo mostly beneficial in the combined therapy group. Body pain and analgesic need in Group 1 was lower than in Groups 2, 3 or 4. Side-effects were registered rarely without statistical differences in frequency between groups. Combination therapy with Tamsulosin + Tadalafil is an effective and safe option that achieves the statistically more significant relief of USRs comparing with Tadalafil or Tamsulosin monotherapies.