Combined gabapentin and solifenacin for symptom management after double-J stent insertion: Randomized controlled trial

ABSTRACT Introduction: Ureteral stents are widely used in various urological procedures; however, they are frequently associated with bothersome symptoms that affect patient quality of life. This study aimed to evaluate the additive effect of gabapentin combined with solifenacin in controlling stent-associated symptoms following double-J stent placement after ureteroscopic lithotripsy. Methods: This prospective randomized controlled trial was conducted between 2019 and 2021 at a tertiary referral center. Adult patients who underwent ureteroscopic lithotripsy for unilateral ureteral stones with subsequent double-J stent placement were included. A total of 160 patients were randomized into two groups. The intervention group received gabapentin 100 mg plus solifenacin 5 mg daily, whereas the control group received Solifenacin 5 mg daily plus placebo for 2 weeks. Symptom severity was evaluated using the Ureteral Stent Symptom Questionnaire (USSQ) 2 weeks postoperatively. Results: The mean total USSQ score was significantly lower in the intervention group (75.17 ± 13.90) compared to the control group (87.98 ± 17.44; P < 0.001). In addition, the intervention group demonstrated significant improvements in urinary symptoms, pain, general health, work performance, and other domains (P < 0.05 for all). Conclusions: Gabapentin appears to be a safe and effective adjunct for reducing symptoms associated with ureteral stent placement, particularly reducing pain and improving general health status. Its combination with solifenacin may offer enhanced symptom control and better patient-reported outcomes.