Evaluating the effectiveness and safety of mirabegron and solifenacin combination in patients with double-J stent related overactive bladder symptoms.

This study evaluated the effectiveness and safety of mirabegron (Myrbetriq) and solifenacin (Vesicare) combination in patients with double-J stent-related overactive bladder (OAB) symptoms. The study found that mirabegron and solifenacin combination significantly improved urinary symptoms, OAB symptoms, and the quality of life with manageable side effects in these patients.

A ureteric stent (also called a J-J stent or double-J stent) is a thin, flexible plastic tube that is curled at both ends to avoid damaging the kidney and urinary bladder and prevent it from dislocating. The stent is placed so that its upper end is in the kidney and its lower end is in the urinary bladder. However, almost 80% of patients may develop stent-related symptoms, such as urinary tract infection (UTI), overactive bladder (OAB) symptoms, and lower urinary tract symptoms (LUTS). Double-J stents are needed for patients who have trouble draining urine from the kidneys to the bladder due to a blockage (caused by stones or tumors).

OAB syndrome is characterized by symptoms such as experiencing incontinence (involuntary leakage of urine), having a strong urge to urinate, and being woken up at night due to the need to urinate (nocturia). OAB symptoms can have a significant negative effect on the quality of life of patients.

Oral anti-muscarinic agents such as solifenacin are the typical first line of treatment for OAB. This type of treatment relaxes the muscle of the bladder to prevent it from having spasms. This helps reduce incontinence and reduces the urge to urinate. Another type of drug that can treat OAB is a beta3-adrenoreceptor agonist such as mirabegron. These drugs lead to bladder muscle relaxation and reduce the need to urinate. However, few studies evaluate the effectiveness and safety of mirabegron and solifenacin combination in patients with double-J stent-related OAB symptoms.

This study involved 219 patients with double-J stent-related OAB symptoms. Patients were randomly assigned into two groups. Group 1 included 109 patients who were treated with mirabegron and solifenacin combination. Group 2 included 110 patients who were treated with solifenacin alone. The LUTS, OAB symptoms, and the health-related quality of life (HR-QoL) were measured and compared at the end of 1^st, 2^nd, and 4^th weeks.

After the 2^nd week, the urgency to urinate was significantly lower in group 1 (44.9%) than in group 2 (64.5%). After the 4^th week, the urgency to urinate was significantly lower in group 1 (14.7%) than in group 2 (30.9%).

After the 2^nd week, frequent urination rates were significantly lower in group 1 (48.6%) than in group 2 (62.7%). After the 4^th week, frequent urination rates were significantly lower in group 1 (16.5%) than in group 2 (33.6%).

After the 2^nd week, incontinence rates were significantly lower in group 1 (40.4%) than in group 2 (56.4%). After the 4^th week, incontinence rates were significantly lower in group 1 (11.9%) than in group 2 (26.4%).

After the 2^nd and 4^th weeks, patients in group 1 had a significantly higher HR-QoL score than patients in group 2. After the 2^nd and 4^th weeks, patients in group 2 experienced significantly higher OAB symptoms than patients in group 1.

Patients in group 2 experienced more treatment-related side effects than patients in group 1. However, this difference was not statistically significant.

This study concluded that mirabegron and solifenacin combination significantly improved urinary symptoms, OAB symptoms, and the HR-QoL with manageable side effects compared to solifenacin alone in patients with double-J stent-related OAB symptoms.

The sample size was very small. The follow-up period was too short. This study was conducted at a single institution in China. Larger studies with a longer follow-up period are necessary to validate the conclusions.