Vardenafil Versus Tamsulosin Efficacy in Relieving Ureteral Stent-Related Symptoms : A Randomized Single Center Study

Background: Urinary symptoms are common side effects following ureteral DJ insertion, different solutions are applied to overcome these symptoms like alpha-adrenergic blockers and phosphodiesterase inhibitors. Aim of the work: To compare the effect of Vardenafil 10 mg once daily versus Tamsulosin 0.4mg once daily on stent-related symptoms (SRSs). Patients and methods: A single center prospective randomized trial was conducted from November 2020 to November 2022 on patients presented with SRSs, randomized to receive either Vardenafil or Tamsulosin for subsequent 4 to 6 weeks. The efficacy of drugs to relieve SRSs was measured by the Ureteral stent symptom questionnaire (USSQ score). Outcomes: The main outcome measure used was the Ureteral stent symptom questionnaire scores, with sexual score analysis regarding gender and age. Results: Of 208 patients, the mean age was 45.07±9.5 years, ranging from 21 to 65 years. There was an improvement regarding urinary symptoms, sexual health, body pain, general health, and work performance after the administration of Vardenafil, p= 0.001. On the other hand, Tamsulosin achieved improvement in most categories except sexual health, p=0.5. Univariate and multivariate analysis of sexual health score in the USSQ showed statistically significant differences toward females and males over 50 years, p= 0.003 and 0.02 respectively. Clinical Implications: both drugs were safe for the patients who were involved in the study, and minimal side effects were reported. Limitations: Vardenafil has a limited half-life, and it was sometimes necessary to add Tamsulosin to enhance its efficacy. Conclusion: Vardenafil is a valid option for SRS relief with favorability toward improving sexual functions in females and elder males.