MANAGING DJ STENT RELATED SYMPTOMS- TAMSULOSIN VS OXYBUTYNIN VS THEIR COMBINATION
DOI:
https://doi.org/10.55519/JAMC-01-13328Keywords:
DJ stent; Endourology; Stent related symptoms; Alpha blockers; AnticholinergicsAbstract
Background: Double J (DJ) stent insertion is a vital procedure in urology, used for urinary diversion, drainage, or support during reconstruction. Common indications include urolithiasis, ureteral strictures, pyeloplasty, or other reconstructive surgeries. Despite its benefits, DJ stenting often leads to stent-related symptoms due to its nature as a foreign object. These symptoms are evaluated using the Ureteral Stent Symptom Questionnaire (USSQ). Various medications, such as alpha blockers and antimuscarinics, have been used to mitigate these effects. This study compares the efficacy and side effects of Tamsulosin (alpha blocker), Oxybutynin (antimuscarinic), their combination, and conservative measures. Methods: A total of 216 patients undergoing unilateral 4.7 Fr DJ stenting for urolithiasis or reconstructive procedures were enrolled and divided into four groups (n=54 each): Group A (Oxybutynin), B (Tamsulosin), C (combination), and D (conservative). Patients under 18, with positive urine cultures, bilateral stents, or who declined participation were excluded. Symptom scores were recorded at 1st and 4th postoperative weeks using USSQ. Results: Combination therapy showed the best symptom control at week 1 (83.3%), while Tamsulosin alone was less effective initially (52.3%, p=0.001). At week 4, Oxybutynin and Tamsulosin groups had similar scores (mean: 39 vs. 40.4). Conservative management resulted in higher symptom scores; 5.5% of these patients required further intervention. Patients with constipation, positive cultures, or those treated for urolithiasis reported worse symptoms across all groups. Conclusion: Combination therapy with Tamsulosin and Oxybutynin offers superior relief from DJ stent-related symptoms compared to monotherapy or conservative approaches.
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