Comparison of Mirabegron plus Tamsulosin and Tamsulosin Monotherapy for the Treatment of Ureteral Stent-Related Symptoms: A Prospective Randomized Study

Introduction: The aim of this study was to compare the efficacy of mirabegron plus tamsulosin to tamsulosin monotherapy in terms of ureteral stent-related discomfort after ureteroscopic lithotripsy. Methods: A total of 102 patients undergoing ureteroscopic lithotripsy and silicone ureteral stent placement were enrolled in this study. Patients were randomized 1:1 to receive either tamsulosin 0.4 mg once daily or mirabegron 50 mg + tamsulosin 0.4 mg once daily during the stenting period. Before the operation, the IPSS, QOL, and pain score were collected. On the day of ureteral stent removal, the USSQ, analgesic usage amount was collected and recorded. Results: The median USSQ-body pain score in the tamsulosin group and tamsulosin + mirabegron group was 15 and 16, respectively (p = 0.530). The median analgesic usage in the two groups was 3 and 2, respectively (p = 0.170). The median USSQ-urinary symptoms, USSQ-general health, USSQ-work performance, USSQ-sexual matters, and USSQ-additional problems in the two groups were 26 and 26 (p = 0.194), 11 and 12 (p = 0.068), 12 and 13 (p = 0.105), 2 and 2 (p = 0.437), 9 and 9 (p = 0.533), respectively. The international patients used more analgesics than Chinese patients (6 vs. 1, p = 0.015). Conclusion: Compared to tamsulosin alone, tamsulosin + mirabegron showed no additional benefit on the ureteral stent-related pain control after ureteroscopic lithotripsy and silicone stent placement. There was no significant difference on the analgesic usage and USSQ scores between the two groups. Chinese patients request fewer analgesics than international patients.