Abstract
Background: Double-J stent is well known for relieving urinary tract obstruction, but still, some patients might develop double-J stent-related urinary tract infection (UTI), lower urinary tract symptoms (LUTS), lower abdominal pain, and hematuria. This study aims to compare alpha-blockers and antimuscarinics for the treatment of double-j stent-related lower urinary tract symptoms.
 Methodology: Patients planned for double-J stent insertion undergoing the urological procedure for ureteric stones were recruited and randomly allocated into two groups. One group was labeled as the tamsulosin (T), and the other was labeled as the solifenacin succinate (S) group. Group" T" patients were prescribed tamsulosin 0.4 mg once at bedtime and solifenacin succinate 10mg once daily to group "S" for 2 weeks. Improvement in symptoms was checked by means of international prostate symptom score (IPSS)/ quality of life (QoL) score charts for LUTS in the out-patient clinic at baseline and at follow-up. 
 Results: When comparing the absolute changes in IPSS/QoL for LUTS scores, both groups showed significant improvement in double-J stent-related lower urinary symptoms, body pain, generalized body weakness, and sexual function, which affect their quality of life (QoL). The mean index score of all domains in both groups was significantly less (p<0.001). Tamsulosin and solifenacin succinate (S) group was found equally efficacious on urinary symptoms (26.01 ± 5.65 (pre); 5.74 ± 0.99 (post) vs. 26.61 ± 5.7 (pre); 26.01 ± 0.97 (post), (p≤0.001). Similarly, the score of QoI was also found equally efficacious in both groups in pre and post-insertion on two weeks (4.96 ± 0.7 (pre); 81.58 ± 0.64 (post) vs. 4.99 ± 0.81 (pre); 1.45 ± 0.5 (post) (p<0.001).
 Conclusion: On the basis of results, it is said that a combination of alpha-blockers and antimuscarinic agents has shown significant improvement to reduce double-J stent-related lower urinary symptoms, pain, and quality of life than a single drug alone.
Highlights
The double-J stents are widely used as an integral part of endo-urologic practices as they play a major role in relieving urinary tract obstruction[1,2]
This study aims to compare alpha-blocker and antimuscarinic and the combination of two for the treatment of lower urinary tract symptoms associated with double-J stent
While patients with diabetes (RBS < 180 mg/dl at presentation), hypertension (SBS < 140 mmHg at presentation), active urinary tract infection (UTI), bladder pathology assessed on history and benign prostatic hyperplasia-related lower urinary tract symptoms (LUTS) (IPSS > 7) were excluded
Summary
The double-J stents are widely used as an integral part of endo-urologic practices as they play a major role in relieving urinary tract obstruction[1,2]. Some patients might develop stent-related problems like urinary tract infection (UTI), lower urinary tract symptoms (LUTS), lower abdominal pain, and hematuria despite the usefulness These symptoms have considerable effects on substantial general health, QoL, work performance, and sexual problems in both genders[3,4,5]. Results: When comparing the absolute changes in IPSS/QoL for LUTS scores, both groups showed significant improvement in double-J stent-related lower urinary symptoms, body pain, generalized body weakness, and sexual function, which affect their quality of life (QoL). Conclusion: On the basis of results, it is said that a combination of alpha-blockers and antimuscarinic agents has shown significant improvement to reduce double-J stent-related lower urinary symptoms, pain, and quality of life than a single drug alone
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