A Comparative Analysis of Mirabegron versus Tolterodine for the Management of Irritative Symptoms Caused by Ureteral Stents
DOI:
https://doi.org/10.61919/jhrr.v4i1.579Keywords:
Ureteral stents, Mirabegron, Tolterodine, Irritative urinary symptoms, Lower urinary tract symptoms, Beta 3 agonists, Anticholinergics, Randomized controlled trial, IPSS scoreAbstract
Background: The use of ureteral stents is a common practice in the management of urinary tract obstruction. However, the presence of a stent often leads to irritative lower urinary tract symptoms (LUTS), significantly impacting the patient's quality of life. Traditional management with anticholinergics is limited by side effects, whereas beta 3 agonists like Mirabegron offer a potentially more tolerable alternative.
Objective: To compare the efficacy and tolerability of Mirabegron versus Tolterodine in the management of irritative symptoms associated with ureteral stents.
Methods: This prospective randomized controlled trial was conducted at the Department of Urology and Renal Transplant, Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar, from January 2019 to August 2020. A total of 104 patients who had undergone ureteral stent placement were randomized into two groups: Mirabegron (52 patients) and Tolterodine (52 patients). Inclusion criteria included individuals aged 18 years or older without prior LUTS history. The primary outcome measured was the change in the International Prostate Symptom Score (IPSS) Irritative score from baseline to post-treatment. Data analysis was conducted using SPSS version 25, with paired and unpaired t-tests for within and between-group comparisons, respectively.
Results: The mean age in the Mirabegron group was 29.44 ± 6.25 years, and 28.23 ± 5.97 years in the Tolterodine group. Pre-treatment IPSS Irritative scores were 9.19 ± 3.72 for Mirabegron and 9.88 ± 3.5 for Tolterodine. Post-treatment, scores reduced to 3.27 ± 1.34 in the Mirabegron group and 4.13 ± 1.47 in the Tolterodine group. The change in IPSS Irritative score was 5.92 ± 2.46 for Mirabegron and 5.75 ± 2.10 for Tolterodine, with no significant difference between groups (p > 0.05).
Conclusion: Mirabegron is as effective as Tolterodine in reducing irritative LUTS in patients with ureteral stents, with a comparable side effect profile. These findings support Mirabegron as a viable alternative for patients experiencing LUTS due to ureteral stents.
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References
Scarneciu I, Lupu S, Pricop C, Scarneciu C. Morbidity and impact on quality of life in patients with indwelling ureteral stents: a 10-year clinical experience. Pak J Med Sci. 2015;31(3):522-6.
Mosayyebi A, Manes C, Carugo D, Somani BK. Advances in ureteral stent design and materials. Curr Urol Rep. 2018;19(5):35.
Chew BH, Lange D, Paterson RF, Hendlin K, Monga M, Clinkscales KW, Shalaby SW, Hadaschik BA. Next generation biodegradable ureteral stent in a Yucatan pig model. J Urol. 2010;183(2):765-71.
Duvdevani M, Chew BH, Denstedt JD. Minimizing symptoms in patients with ureteric stents. Curr Opin Urol. 2006;16:77–82.
Taguchi M, Yoshida K, Sugi M, Kinoshita H, Matsuda T. Effect of ureteral stent diameter on ureteral stent-related symptoms. LUTS. 2019;11(4):195-199.
Matsuzaki T, Yoshida T, Murata T, Nakao K, Taguchi M, Kinoshita H, Matsuda T. Complete intraurethral stent placement relieves daytime urinary frequency compared with conventional placement in patients with an indwelling ureteral stent: post-hoc analysis of a randomized, controlled trial. Sci Rep. 2020;10(1):15892.
Tae BS, Cho S, Jeon BJ, Choi H, Park JY, Cho SY, Lee KC, Bae JH. Does mirabegron relieve ureteric stent-related discomfort? A prospective, randomized, multicentre study. BJU Int. 2018;122(5):866-872.
Bragg R, Hebel D, Vouri SM, Pitlick JM. Mirabegron: a Beta-3 agonist for overactive bladder. Consult Pharm. 2014;29(12):823-37.
Chapple CR, Cardozo L, Nitti VW, Siddiqui E, Michel MC. Mirabegron in overactive bladder: a review of efficacy, safety, and tolerability. Neurourol Urodyn. 2014;33(1):17-30.
Thiagamoorthy G, Kotes S, Zacchè M, Cardozo L. The efficacy and tolerability of mirabegron, a β3 adrenoceptor agonist, in patients with symptoms of overactive bladder. Ther Adv Urol. 2016;8(1):38-46.
Batista JE, Kölbl H, Herschorn S, Rechberger T, Cambronero J, Halaska M, Coppell A, Kaper M, Huang M, Siddiqui E; BEYOND study group. The efficacy and safety of mirabegron compared with solifenacin in overactive bladder patients dissatisfied with previous antimuscarinic treatment due to lack of efficacy: results of a noninferiority, randomized, phase IIIb trial. Ther Adv Urol. 2015;7(4):167-79.
Sacco E, Bientinesi R. Mirabegron: a review of recent data and its prospects in the management of overactive bladder. Ther Adv Urol. 2012;4(6):315-24.
Warren K, Burden H, Abrams P. Mirabegron in overactive bladder patients: efficacy review and update on drug safety. Ther Adv Drug Saf. 2016;7(5):204-216.
Wagg A, Franks B, Ramos B, Berner T. Persistence and adherence with the new beta-3 receptor agonist, mirabegron, versus antimuscarinics in overactive bladder: early experience in Canada. Can Urol Assoc J. 2015;9(9-10):343-50.
Anastasios A, Konstantinos G. An overview of the clinical use of antimuscarinics in the treatment of overactive bladder. Adv Urol. 2011;2011.
Fryer S, Nicoara C, Dobson E, Griffiths M, McAndrew HF, Kenny SE, Corbett HJ. Effectiveness and tolerability of mirabegron in children with overactive bladder: a retrospective pilot study. J Pediatr Surg. 2020;55(2):316-318.
Blais AS, Nadeau G, Moore K, Genois L, Bolduc S. Prospective pilot study of mirabegron in pediatric patients with overactive bladder. Eur Urol. 2016;70(1):9-13.
Griebling TL, Campbell NL, Mangel J, Staskin D, Herschorn S, Elsouda D, Schermer CR. Effect of mirabegron on cognitive function in elderly patients with overactive bladder: MoCA results from a phase 4 randomized, placebo-controlled study (PILLAR). BMC Geriatr. 2020;20(1):109.
Otsuki H, Yamasaki T, Hori S, Aoki H, Kosaka T, Uehara S et al. The efficacy of mirabegron for the relief of ureteral stent-related symptoms. Acta Medica Okayama. 2020;74(2):145-50.
Zhou L, Cai X, Li H, Wang KJ. Effects of α-blockers, antimuscarinics, or combination therapy in relieving ureteral stent-related symptoms: a meta-analysis. J Endourol. 2015;29(6):650-6.
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