This trial aimed to evaluate the efficacy of alpha-1A blocker (Alfuzocin ), antimuscarinic (solifena- cin), and their combination in the management of dou- ble-J stent-related lower urinary tract symptoms using the International Prostate Symptom Score (IPSS), QoL score, and Visual Analog Scale (VAS).

Background: The insertion of a double-J (DJ) stent is considered a routine and necessary urological procedure. It can cause lower urinary tract symptoms (LUTS). Pharmacologic management is one of many trials that were done to improve these symptoms, particularly the administration of alpha-1A blockers and antimuscarinics medications. This trial aimed to evaluate the efficacy of alpha-1A blocker (Alfuzocin ), antimuscarinic (solifenacin), and their combina- tion in managing DJ stent-related LUTS.
Methods: This prospective, randomized, comparative, and nonblinded trial was conducted between January 2019 and December 2022 . Eligible patients were between 18 and 58 years of both genders who underwent temporary retrograde unilateral Double-J stent fixation. Patients were randomized to four groups; group I was control (drug-free), group II received Alfuzocin  10 mg, group III received solifenacin 5 mg, and group IV received the combination of  Alfuzocin and solifenacin. All patients completed the IPSS, QoL, and VAS questionnaires at both pre-insertion day of the stent and 2 weeks postoperatively; the data obtained were compared to all four groups.

The study included  340 patients ( 240  males, 100 females). There was no statistically significant difference between the four groups regarding age, sex, side, and DJ placement indications. In comparison with the control group, there were statistically significant differences in all scores in favor of groups II, III, and IV. Compared to groups II and III, there were statistically significant differences in overall IPSS, QoL, and VAS scores in group IV. No significant differences were found between the Alfuzocin and solifenacin groups.

There was no statistically significant difference between the four groups regarding age, sex, side, and DJ placement indications. In comparison with the control group, there were statistically significant differences in all scores in favor of groups II, III, and IV. Compared to groups II and III, there were statistically significant differences in overall IPSS, QoL, and VAS scores in group IV. No significant differences were found between the  Alfuzocin and solifenacin groups

The alpha-1A blocker (Alfuzocin ) or antimuscarinic (solifenacin) monotherapy effectively improves the DJ stent-related LUTS and the QoL of patients with no advantage with either drug. The combination therapy of both pharmacotherapies is significantly effective than drug monotherapy.

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