Comparative Efficacy of Tamsulosin and Solifenacin in Managing Double J Stent-Related Symptoms: A Randomized Clinical Study Using the USSQ Tool

Background: Double-J stents relieve obstruction but often cause urinary symptoms and pain that impair quality of life. Objective: To compare solifenacin vs. tamsulosin for relief of stent-related symptoms using the Ureteral Stent Symptom Questionnaire (USSQ). Methods: This open-label randomized controlled trial was conducted at Liaquat National Hospital from June to December 2024. Adults (20-50 years) with unilateral DJ stents were assigned to tamsulosin 0.4 mg daily or solifenacin 5 mg daily for 14 days. Symptoms were assessed on day 14 with the USSQ. Results: A total of 60 patients were enrolled, with 30 patients in each treatment group. Solifenacin produced lower total USSQ scores than tamsulosin (60.5 ± 8.3 vs. 74.2 ± 7.8, p<0.001). Solifenacin also demonstrated significantly better scores across individual domains of the USSQ: urinary index (22.6±3.9 vs. 29.1±3.5, p<0.001), pain index (13.1±3.2 vs. 16.9±3.4, p=0.002), general health index (13.6±2.7 vs. 15.8±2.9, p =0.005), and work performance index (7.5 ± 2.0 vs. 9.4 ±2.2, p=0.001). Sexual function did not differ (2.3±2.0 vs. 2.7±2.5, p=0.450). Adverse events were mild (dry mouth with solifenacin; dizziness with tamsulosin); no discontinuations occurred. Conclusion: Solifenacin was more effective than tamsulosin for short-term relief of DJ stent-related symptoms and may be considered the preferred monotherapy. Multicentre studies with longer follow-up are warranted. Trial registration: ClinicalTrials.gov NCT07114848.