tolterodine-tartrate and Pain

We performed a randomized, prospective study to assess the possible role of combined tamsulosin and tolterodine therapy for the relief of vesical irritability and in facilitating the spontaneous expulsion of intramural ureteral stones. Patients were randomized to one of three treatment groups. Treatment group 1 patients received tamsulosin 0.4 mg/day, group 2 patients received tamsulosin 0.4 mg/day plus tolterodine 2 mg (twice a day), and group 3 patients received tolterodine 2 mg (twice a day). Subjects rated the urgency associated with each micturition using the Urinary Sensation Scale. Pain descriptions were recorded by the patients using the Visual Analog Scale. Stone expulsion was observed in 30 patients in group 1, 29 patients in group 2 and 18 patients in group 3. Kaplan-Meier curves were plotted to access the expulsion rate of each group over time. A significant difference was shown for the expulsion rate between the tolterodine group and the other two groups. (P = 0.003 by log rank test). Average time to expulsion for groups 1, 2 and 3 was 7.62 ± 2.42, 7.79 ± 2.11 and 10.57 ± 2.71 days, respectively (P = 0.000). In groups 1, 2 and 3, the mean number of pain episodes was 2.27 ± 0.91, 1.39 ± 1.34 and 1.38 ± 1.20, respectively (P = 0.023). Treatment with tamsulosin and tolterodine appears to be beneficial in intramural ureteral stone clearance, particularly in intramural ureter stone with symptoms of vesical irritability.

Topics: Adult; Benzhydryl Compounds; Cresols; Drug Therapy, Combination; Female; Humans; Male; Pain; Phenylpropanolamine; Prospective Studies; Sulfonamides; Tamsulosin; Tolterodine Tartrate; Treatment Outcome; Ureteral Calculi; Urological Agents

We evaluated the clinical results of tolterodine in treating impacted stones in the intramural ureter with symptoms of vesical irritability. A total of 80 patients with intramural ureter stones were included in the study from December 2007 to November 2009. Patients were randomly divided into two groups. The 41 patients in group A were given a watchful waiting and served as control group. Group B received 2 mg tolterodine (twice a day). Both groups were followed up for 2 weeks. The stone expulsion rate and time and the number of pain episodes were obtained. Subjects rated the urgency associated with each micturition using the Urinary Sensation Scale (USS). Pain descriptions were recorded by the patients using the Visual Analog Scale (VAS). The stone expulsion rate in groups A and B was 56.1 and 56.4%, respectively (P = 0.98). The mean numbers of renal colic episodes of patients in groups A and B had experienced 4.5 and 1.7, respectively. The USS for groups A and B in 3 and 7 days were 2.89 ± 0.56, 1.29 ± 0.60; 1.98 ± 0.79, 1.09 ± 0.3, respectively (P < 0.001). Statistically significant difference was found between groups A and B in relation to the VAS score on days 3 and 7, respectively (P < 0.001). While our study demonstrated no improvement in expulsion rate, Tolterodine reduced the common symptoms of frequency, urgency, intensity of the pain episodes and discomfort often associated with intramural ureter stone.

Topics: Adult; Benzhydryl Compounds; Cresols; Female; Humans; Male; Muscarinic Antagonists; Pain; Pain Measurement; Phenylpropanolamine; Retrospective Studies; Tolterodine Tartrate; Treatment Outcome; Ureteral Calculi; Urinary Bladder, Overactive; Watchful Waiting