Is there a role for alpha1-blockers in treating double-J stent-related symptoms?

To evaluate the effect of alfuzosin in improving symptoms in, and quality of life of, patients with indwelling double-J ureteral stents.

A total of 100 patients, 50 men and 50 women (mean age 54.2 years), with unilateral ureteral stone-related hydronephrosis, who had opted for conservative management with insertion of a double-J ureteral stent, were prospectively randomized into two groups. Group 1 included 50 patients who received 10 mg of alfuzosin, once daily for 4 weeks, and group 2 consisted of 50 patients who received placebo for the same period. All patients completed a validated Ureteral Stent Symptom Questionnaire (USSQ) 4 weeks after stent placement.

The mean urinary symptom index score was 21.6 in group 1 and 28.1 in group 2 (P < 0.001). Stent-related pain was reported by 44% of patients in group 1 and 66% of patients in group 2 (P = 0.027). The mean pain index score was 14.6 in group 1 and 17.4 in group 2 (P = 0.047). The mean general health index score was statistically greater (P < 0.001) in group 1 compared with in group 2 (8 versus 11.4, respectively). Among sexually active patients, the mean sexual score was 2.3 in group 1 and 2.9 in group 2 (P = 0.017).

Stent-related symptoms were present in 66% of the controls (group 2). Alfuzosin improved a subset of stent-related urinary symptoms and pain. Patients receiving alfuzosin had their sexual function and general health better preserved.