From the Research
Tamsulosin is not routinely required for all patients after double J ureteral stent placement, but it may be beneficial for many patients to reduce stent-related symptoms, as shown in a study published in 2014 1. When prescribed, tamsulosin is typically given at a dose of 0.4 mg once daily until stent removal. The medication works by relaxing smooth muscle in the ureter and bladder neck, which can decrease the frequency and severity of common stent-related symptoms such as flank pain, urinary urgency, frequency, and dysuria. These symptoms, collectively known as "stent discomfort syndrome," affect up to 80% of patients with ureteral stents. Some key points to consider when deciding whether to prescribe tamsulosin include:
- The patient's symptom severity
- The expected duration of stent placement
- Contraindications to alpha-blocker therapy Patients should be informed that tamsulosin may cause side effects including dizziness, orthostatic hypotension, retrograde ejaculation in men, and nasal congestion. Alternatives for stent discomfort include anticholinergics like solifenacin or non-steroidal anti-inflammatory drugs, which may be used alone or in combination with tamsulosin depending on symptom presentation. However, a more recent study from 2017 2 suggests that Tolterodine may be more effective in minimizing stent-related urinary symptoms and improving general health in patients with double J stents. Therefore, the decision to prescribe tamsulosin or alternative medications should be individualized based on the patient's specific needs and medical history. It's also worth noting that the long-term use of tamsulosin has been shown to be safe and well-tolerated in patients with lower urinary tract symptoms/benign prostatic hyperplasia, with sustained improvement in symptoms over a period of up to 4 years 3.