الفهرس 
ANATOMICAL STRUCTURE OF THE URETEROnly 14 pages are availabe for public view
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Abstract
U
reteral stents play a major role in a wide range of situations where urinary drainage is needed, the double-J stent which is the most common form of ureteral stent, has been used in obstructive pyelonephritis, intolerable acute renal colic, ureteral edema, ureter perforation following endoscopic procedures, and renal failure secondary to ureteral obstruction.
Despite the usefulness of stents, some of the patients might encounter stent-related complications such as urinary tract infection (UTI), lower urinary tract symptoms (LUTS), stent-related body pain, and hematuria. These symptoms represent a prevalent problem with considerable effects on the quality of life, substantial general health, work performance, and sexual performance in both genders.
For this reason, several attempts to minimize stent-related symptoms have recently been reported. Pharmacologic management is one of these trials, especially the prescription of selective alpha-1-blockers as tamsulosin and antimuscarinic agents as solifenacin.
The aim of the present study was to analyze and assess the effectiveness of a selective alpha-1-blocker (tamsulosin) and antimuscarinic (solifenacin) and their combination in improving the lower urinary tract symptoms of patients with indwelling double-J ureteral stents.
The present study was a prospective randomized controlled comparative study conducted on 112 patients with double-J stent inserted in Ain Shams University Hospital and El-Agouza hospital. over a period of 6 months.
The patients were randomized into 4 equal groups (1:1:1:1 randomization): group A: 28 patients were received a daily oral dose of pepon plus as a placebo drug (control group). group B: 28 patients were treated by Tamsulosin (0.4 mg) alone once daily. group C: 28 patients were treated by Solifenacin (5 mg) once daily. group D: 28 patients were treated by Tamsulosin (0.4 mg) once daily in combination with Solifenacin (5 mg) once daily. All patients were assessed first day postoperatively after Double-J stent insertion. Then, the patients were start the medical treatment and were assessed on the first and third week post treatment.
The study shows that the combination of the tamsulosin 0.4 mg/day and the solifenacin 5 mg /day are significantly different from tamsulosin only, solifenacin only and placebo groups. Generally superior to the all-other groups for the stent related symptoms treatment. However, regarding the comparison between solifenacin only group and tamsulosin only group, the solifenacin only group was generally superior to tamsulosin group and both are better than placebo group.