Mirabegron Versus Tamsulosin in Reducing Double-J Stent-Related Symptoms: A Prospective Comparative Study.

Introduction Double-J (DJ) ureteral stents are widely used in endourology to relieve upper tract obstruction and ensure adequate postoperative drainage. However, stent-related symptoms (SRS), including lower urinary tract symptoms (LUTS), flank pain, haematuria, and discomfort, significantly impair patient quality of life. Pharmacologic interventions, such as alpha-blockers and beta-3 adrenergic agonists, have been proposed to mitigate SRS. This study aimed to compare the efficacy and safety of mirabegron versus tamsulosin in reducing DJ SRS. Materials and methods This prospective observational study was conducted at Shri B. M. Patil Medical College, Vijayapura, India (IEC No: BLDE (DU)/IEC/997/2022-23), between July 2023 and July 2024. A total of 130 adult patients with indwelling ureteral stents following endourological procedures were enrolled and allocated into two groups: Group A received tamsulosin 0.4 mg once daily, and Group B received mirabegron 50 mg once daily, continued until stent removal. Symptom assessment was performed at two and three weeks using the validated Ureteral Stent Symptom Questionnaire (USSQ). Safety profiles were also documented. Results Both groups demonstrated progressive symptom improvement over three weeks. Mirabegron showed significantly lower urinary symptom scores (12.1 vs. 15.6 at two weeks; 9.4 vs. 13.2 at three weeks, p < 0.001) and body pain scores (4.5 vs. 6.8 at two weeks; 3.1 vs. 5.4 at three weeks, p < 0.001). Improvements in general health, sexual function, and work performance favoured mirabegron, but were not statistically significant. Mirabegron exhibited a favourable safety profile, with fewer minor adverse events. Conclusions Mirabegron 50 mg once daily provides superior relief of urinary symptoms and pain compared to tamsulosin 0.4 mg once daily, with good tolerability and improved overall quality of life in patients with indwelling DJ ureteral stents.