Efficacy of tolterodine for medical treatment of intramural ureteral stone with vesical irritability.

We evaluated the clinical results of tolterodine in treating impacted stones in the intramural ureter with symptoms of vesical irritability. A total of 80 patients with intramural ureter stones were included in the study from December 2007 to November 2009. Patients were randomly divided into two groups. The 41 patients in group A were given a watchful waiting and served as control group. Group B received 2 mg tolterodine (twice a day). Both groups were followed up for 2 weeks. The stone expulsion rate and time and the number of pain episodes were obtained. Subjects rated the urgency associated with each micturition using the Urinary Sensation Scale (USS). Pain descriptions were recorded by the patients using the Visual Analog Scale (VAS). The stone expulsion rate in groups A and B was 56.1 and 56.4%, respectively (P = 0.98). The mean numbers of renal colic episodes of patients in groups A and B had experienced 4.5 and 1.7, respectively. The USS for groups A and B in 3 and 7 days were 2.89 ± 0.56, 1.29 ± 0.60; 1.98 ± 0.79, 1.09 ± 0.3, respectively (P < 0.001). Statistically significant difference was found between groups A and B in relation to the VAS score on days 3 and 7, respectively (P < 0.001). While our study demonstrated no improvement in expulsion rate, Tolterodine reduced the common symptoms of frequency, urgency, intensity of the pain episodes and discomfort often associated with intramural ureter stone.