Effects of terazosin and tolterodine on ureteral stent related symptoms: A double-blind placebo-controlled randomized clinical trial

evaluate the effects of terazosin and tolterodine on ureteral stent discomfort.
Materials and Methods: Of 163 patients assessed for eligibility, 104 patients were randomly
assigned to receive placebo, 2 mg of terazosin twice daily, 2 mg of tolterodine
daily, or both terazosin plus tolterodine during the stenting period. Prior to stenting and
at stent removal, the International Prostate Symptom Score (IPSS), the IPSS quality of life
(QoL) subscore and the Visual Analog Scale for Pain were determined. The patients also
reported their analgesic use during the stenting period.
Results: Ninety-four patients completed the study. We noted significant decreases in the
total IPSS scores (p = 0.002), irritative subscore (p = 0.039), QoL (p = 0.001), flank pain (p
= 0.013), voiding pain (p = 0.01) and amount of analgesics used (p = 0.02) in the groups.
However, neither the obstructive subscore nor the suprapubic pain improved significantly
(p = 0.251 and p = 0.522, respectively). The patients receiving terazosin plus tolterodine
experienced significant reductions in the total IPSS, irritative symptoms, QoL, flank pain,
voiding pain and decreased analgesics use compared with those patients receiving placebo.
However, compared with placebo, terazosin monotherapy did not affect pain levels,
and tolterodine monotherapy did not improve QoL, flank pain or analgesics use.
Conclusions: Terazosin plus tolterodine improves ureteral stent-related complications,
including irritative symptoms, the amount of analgesics used, QoL, flank pain and voiding
pain but does not decrease obstructive symptoms or suprapubic pain. This trial was
registered at www.clinicaltrials.gov as NCT01530243.