POL Scientific / Bladder / Volume 11 / Issue 3 / DOI: 10.14440/bladder.2024.0018
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REVIEW

Pharmacological treatment of bladder stent symptoms

John C. P. Piedad1* ,  Mazen Allam1 ,  Wasim Mahmalji1
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1 Department of Urology, Wye Valley NHS Trust, Hereford County Hospital, Hereford HR1 2ER, United Kingdom
Bladder 2024 , 11(3), e21200012; https://doi.org/10.14440/bladder.2024.0018
Submitted: 18 July 2024 | Revised: 20 August 2024 | Accepted: 12 September 2024 | Published: 4 November 2024
© 2024 by the Bladder published by POL Scientific. Licensee POL Scientific, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: Ureteric stenting is a ubiquitous procedure, but it is associated with symptoms that affect psychological well-being and quality of life. While many factors are linked to worse symptomatology, some innovative modifications to the stent’s structure, as well as treatments, have been studied to reduce their clinical impact. Pharmacotherapy is a well-evaluated treatment modality derived from the treatment of lower urinary tract symptoms not related to stents. Objective: This review focuses on these pharmacological treatments. Several drug classes have been trialed to treat stent-related symptoms. Most of these studies investigated adrenoceptor modulators (both alpha-blockers and beta-3 agonists), muscarinic receptor antagonists, phosphodiesterase-5 inhibitors, as well as novel pharmacological modalities. Most trials and subsequent meta-analyses support treatment over placebo and controls, and some drugs are better at treating certain symptom domains, such as phosphodiesterase-5 inhibitors working on sexual issues. Furthermore, a combination therapy with alpha-blockers and muscarinic receptor antagonists appears to be superior to monotherapy with either of them. Treatments are also well tolerated. Conclusion: However, initiating pharmacotherapy should be part of a shared decision-making approach that balances the severity of symptoms and the duration the stents will remain in situ against potential side effects.

Keywords
Pharmacotherapy
Stent symptoms
Ureteric stent
Funding
None.
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Conflict of interest
The authors declare no conflicts of interest.
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