الفهرس 
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Abstract
S
UMMARY
fter almost five decades of internal ureteral stenting, this endourological standard procedure is still associated with a clear side-effect profile. Thus, ureteral stents should be avoided whenever possible, and removed as soon as possible. However, ureteral stenting remains unavoidable in a considerable number of our patients. In these cases, a proper stent length should be chosen, and patients should be informed thoroughly about potential side-effects and treated with a1-blockers or antimuscarinics.
The mechanism of action of antimuscarinic selective m3 blocker Darifenacin as medical treatment for ureteric stent related symptom is to reduce the frequency of contractions by antagonizing parasympathetic control of the bladder; they also may alter bladder sensation during filling with side effects as xerostomia, blurred vision, and GI side effects such as constipation and dyspepsia. CNS-related antimuscarinic effects, including drowsiness, dizziness, and confusion, can occur and are particularly problematic in elderly patients but less likely as darifenacin is relatively selective for M3 receptors and therefore has minimal effects on M1 receptors in the CNS.
While the mechanism of PDE-5 inhibitors reduce ureteral spasm, relaxes the ureteric smooth muscle and improvement of irritative urinary symptoms.
A
Summary
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The aim of the present study was to analyze and compare the safety and efficacy of darifenacin versus tadalafil in the relief of ureteric stent related symptoms.
This is a randomized comparative blind cross over study conducted on 150 patients admitted in the department of Urology in Ain shams University Hospitals, All patients underwent DJ stenting after urological interventions were enrolled in the study, according to inclusion and exclusion criteria, 150 patients were included in The study which were randomly divided one by one in to 2 groups 75 patients each The study was divided into two parts each part last for 3 weeks, in the 1st part of the study group 1 received Tadalafil 5 mg tab once daily orally and group 2 received darifenacin 7.5 mg once daily orally and then treatment stopped for one week for wash out of the drug.
In the 2nd part of the study the two groups switched as follow: group 1: received darifenacin 7.5 mg tab once daily orally and group 2: received Tadalafil 5 mg tab once daily orally.
Follow-up was performed after each part of the study by asking the patient about the grade of five symptoms (incomplete emptying, frequency, urgency, nocturia and pain) and side-effects of the drugs.
In this study we found that there was highly significant improvement of ureteric stent related symptoms in favor of Darifenacin 7.5 mg when compared with tadalafil 5mg. Both of these medications demonstrated a good safety and tolerability profile for medical improvement therapy in patients with ureteric stents.