Efficacy and Tolerability of Tadalafil 5mg Once Daily versus Darifenacin for Ureteric Stent Related Symptoms

Abstract Background After almost five decades of internal ureteral stenting, this endourological standard procedure is still associated with a clear side-effect profile. Thus, ureteral stents should be avoided whenever possible, and removed as soon as possible. However, ureteral stenting remains unavoidable in a considerable number of our patients. In these cases, a proper stent length should be chosen, and patients should be informed thoroughly about potential side-effects and treated with a1-blockers or antimuscarinics. Aim of the Work The aim of the present study was to analyze and compare the safety and efficacy of darifenacin versus tadalafil in the relief of ureteric stent related symptoms. Patients and Methods This is a randomized comparative blind cross over study conducted on 150 patients admitted in the department of Urology in Ain Shams University Hospitals, All patients underwent DJ stenting after urological interventions were enrolled in the study, according to inclusion and exclusion criteria, 150 patients were included in The study which were randomly divided one by one in to 2 groups 75 patients each The study was divided into two parts each part last for 3 weeks, in the 1st part of the study Group 1 received Tadalafil 5 mg tab once daily orally and Group 2 received darifenacin 7.5 mg once daily orally and then treatment stopped for one week for wash out of the drug. In the 2nd part of the study the two groups switched as follow: Group 1: received darifenacin 7.5 mg tab once daily orally and Group 2: received Tadalafil 5 mg tab once daily orally. Results Which was proved in the 2nd part of the study after wash out period (one week) as patients in group 1 which was converted to darifenacin 7.5 mg were found better than patients in group 2 which was converted to tadalafil 5 mg as regard sense of incomplete emptying with mean score (1.88 ± 0.88vs 4.24 ± 0.71), regarding frequency there was improvement in group 1 than in group 2 with mean score (1.44 ± 0.83 vs 4.12 ± 0.75), as regard urgency there was improvement in group 1 than in group 2 with mean score (1.8 ± 0.82vs 3.99 ± 0.76), as regard nocturia there was improvement in group 1 than in group 2 with mean score (0.97 ± 0.7vs 3.52 ± 0.78), and as regard pain there was improvement in group 1 than in group 2 with mean score (2.45 ± 0.58vs 2.71 ± 0.65). Conclusion The study showed highly significant improvement of ureteric stent related symptoms in favor of Darifenacin 7.5 mg when compared with tadalafil 5mg. Both of these medications demonstrated a good safety and tolerability profile for medical improvement therapy in patients with ureteric stents.