Vardenafil and Tamsulosin in the Management of Ureteral Stent–Related Symptoms: A Prospective Comparative Study

Objective: This study aimed to compare the effectiveness of vardenafil, a phosphodi-esterase-5 inhibitor, and tamsulosin, an alpha-blocker, in the management of ureteral srtent-elated symptoms. Methods: A total of 208 patients who underwent ureteric stent placement after the removal of ureteric stones were enrolled and randomly divided to receive either var- denafil 10 mg daily or tamsulosin 0.4 mg daily for a duration of 3 weeks. The validated Ureteral Stent Symptom Questionnaire (USSQ) was used to assess patients at baseline and after 3 weeks from starting the medications. Results: This study compared tamsulosin and vardenafil in 208 patients (101 vs. 107) with a mean age of 45.07 ± 9.5 years, predominantly male (67.4%); both groups were similar in baseline characteristics (P >.05). A notable statistical significant reduction in total scores from the first visit to the fourth visit (vardenafil: 136.03 to 85.01; tamsulosin: 129.9 to 97). Vardenafil showed a statistically significant improvement (P <.001) compared to tamsulosin across all USSQ domains except body pain, which has statistically significant improvement in the tamsulosin group. During the follow-up visits, vardenafil had statistically significant improvement in all USSQ domains; however, tamsu- losin had statistically significant improvement in all USSQ domains except in sexual health (P =.5). Side effects were mild, with retrograde ejaculation and hypotension in the tamsulosin group and headaches in the vardenafil group. Conclusion: Vardenafil showed promising results in controlling stent-related symptoms and can be considered an alternative or adjunct medication to tamsulosin in the management of stent-related symptoms; however, this needs further exploration in larger, multi-center studies to validate these findings and optimize patient outcomes in clinical practice.