Comparison of Solifenacin Versus Mirabegron in Reducing Pain and Irritative Lower Urinary Tract Symptoms in Patients with Double J Stent

Abstract

Background: Double-J ureteral stents are commonly used after endourological procedures but frequently cause pain and irritative lower urinary tract symptoms that impair quality of life. Pharmacological strategies aim to mitigate these symptoms, yet the optimal agent remains debated. Objective: To compare the efficacy and safety of solifenacin and mirabegron in reducing pain and irritative lower urinary tract symptoms in patients with indwelling Double-J stents. Methods: In this randomized double-blind trial, 232 patients with Double-J stents were allocated to receive solifenacin 5 mg or mirabegron 50 mg once daily for four weeks. Pain intensity was assessed using a visual analogue scale, while irritative urinary symptoms were evaluated using a structured symptom questionnaire. Adverse events were recorded throughout follow-up. Results: Both treatments significantly reduced pain and urinary symptoms; however, mirabegron resulted in a greater reduction in mean pain scores at four weeks (p = 0.01). Improvement rates for urgency, urgency incontinence, frequency, and nocturia were significantly higher in the mirabegron group (all p < 0.01). Solifenacin was associated with more anticholinergic adverse effects, whereas mirabegron showed only mild, transient hypertension in a small proportion of patients. Conclusion: Mirabegron demonstrated superior efficacy and better tolerability compared with solifenacin in managing Double-J stent–related pain and irritative urinary symptoms, supporting its use as a preferred therapeutic option.