A comparative study of mirabegron versus doxazosin in improving ureteral stent-related dysfunction

Abstract

Objective: To compare the efficacy of mirabegron and doxazosin in alleviating ureteral stent-related symptoms and sexual dysfunction. Method: This study included 107 patients who provided informed consent and underwent transurethral ureteral lithotripsy with ureteral stent placement between January 2023 and December 2023. Patients were randomized into two groups receiving either mirabegron (50 mg/day) or doxazosin (4 mg/day). The Ureteral Stent Symptom Questionnaire (USSQ) scores and adverse drug reactions were recorded at baseline (ureteral stent placement), 2 weeks (ureteral stent removal), and 4 weeks (2 weeks after stent removal). The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2500095161). Results: At 2 weeks, the mirabegron group showed a greater improvement in pain during intercourse compared to the doxazosin group (0.379 ± 0.186; p = 0.043). This improvement persisted at 4 weeks (0.363 ± 0.186). No significant differences were observed in sexual satisfaction scores between the groups at either time point (2 weeks: 0.175 ± 0.186, p = 0.350; 4 weeks: 0.157 ± 0.186, p = 0.401). Subgroup analysis revealed that mirabegron provided greater relief of pain during intercourse in women compared to doxazosin (OR = 14.40, 95% CI 1.53-135.51, p = 0.020). Additionally, women in the doxazosin group reported significantly lower sexual satisfaction compared to the mirabegron group (OR = 42.00, 95% CI 2.41-825.71, p = 0.014). Conclusions: Mirabegron and doxazosin demonstrated similar efficacy in relieving ureteral stent-related symptoms. However, mirabegron offered a clear advantage in improving female sexual function, particularly regarding pain during intercourse and overall satisfaction.