Gabapentin and solifenacin combo safe and effective option for reducing discomfort associated with ureteral stents: Study

Although double-J (DJ) stents are vital urological tools, they frequently trigger debilitating lower urinary tract symptoms (LUTS) like urgency and pain; previous research has favored solifenacin, yet a clinical gap remained regarding the benefit of adjunctive gabapentin until Salman Soltani and colleagues from the Mashhad University of Medical Sciences investigated this combination to optimize post-procedural care.

Therefore, the prospective randomized controlled trial (RCT) involving 160 adults at a tertiary hospital compared a two-week regimen of 5 mg solifenacin plus 100 mg gabapentin against solifenacin plus a placebo following unilateral ureteroscopic lithotripsy (URS). The methodology excluded patients with chronic analgesic use or neurogenic bladder conditions, focusing on primary changes in Ureteral Stent Symptom Questionnaire (USSQ) domains to evaluate efficacy.

Key Clinical Findings of the Study Include:

• Decreased Urinary Frequency: Study data revealed that patients receiving the dual therapy experienced significantly fewer instances of daytime frequency compared to those on monotherapy (P < 0.001).

• Enhanced Pain Relief: Research indicated that the combination group reported significantly lower scores for pain during voiding, measuring 2.00 versus 4.00 in the control group.

• Superior Health Perception: Investigation findings showed that the intervention group achieved better general health scores of 9.00 compared to 11.00 in the control cohort.

• Lower Incontinence Rates: Trial analysis confirmed a significant reduction in urge incontinence episodes for patients treated with both medications compared to the placebo group (P = 0.002).

• Improved Overall Outcomes: Analysis demonstrated a significant drop in the total symptom score to 75.17 for the intervention group, while the control group remained higher at 87.98.

The results suggest that the synergistic effect of low-dose gabapentin and solifenacin offers a safe and potent solution for mitigating stent-related discomfort and improving patient well-being, specifically lowering average total symptom scores by over 12 points.

These findings indicate that medical practitioners may consider adopting this combined pharmacological approach to more effectively manage the complex array of symptoms that patients often face after the placement of a urinary stent.

While the research was limited by its single-blinded nature and a narrow focus on specific baseline variables, future inquiries utilizing double-blinded designs and longer observation periods could further refine these clinical strategies.

Reference

Soltani S, Tavakkoli M, Emadzadeh M, Ghorbani H, Tabassi KT, Aghaee A, et al. Combined gabapentin and solifenacin for symptom management after double‑J stent insertion: Randomized controlled trial. Indian J Urol 2026;42:115-21.