PURPOSE: We evaluated the effects of α-blockers, antimuscarinics or combination of both in reducing ureteral stent related symptoms.
METHODS: The relevant studies were identified by searching MEDLINE, EMBASE and Cochrane Library Database from January 2000 to May 2014. Randomized controlled trials evaluating effects of α-blocker, antimuscarinic and combination therapy for stent related symptoms were included. Two reviewers independently screened studies and extracted data.
RESULTS: A total 13 articles were identified including 1408 patients. There were statistically significant difference in urinary symptom (－6.37; p < 0.0001) and body pain index score (－7.03; p = 0.0008) of Ureteric Stent Symptom Questionnaire (USSQ), total International Prostate Symptom Score (IPSS) (－4.16; p = 0.0006), Visual Analogue Pain Scale (VAPS) score (－2.48; p < 0.00001), and quality of life (QoL) (－1.42; p = 0.0009) in favor of α-blocker group. Antimuscarinics alone versus control group showed significant improvement in total IPSS (MD: －3.76; 95% CI, －5.08 to －2.43; p < 0.00001) and QoL (MD: －0.82; 95% CI, －1.31 to －0.32; p = 0.001). As compared to α-blockers monotherapy, combination therapy has significant lower total IPSS (MD: －3.74; 95% CI, －4.94 to －2.54; p < 0.00001), VAPS (MD: －0.50; 95% CI, －0.89 to －0.11; p = 0.01), and QoL (MD: －0.93; 95% CI, －1.30 to －0.55; p < 0.00001).
CONCLUSIONS: Our data showed the beneficial effect of α-blockers alone and antimuscarinics alone in reducing stent related symptoms. Furthermore, we suggested significant advantages of combination therapy of α-blocker and antimuscarinic as compared to α-blocker monotherapy. However, more high quality, randomized controlled trials are warranted to better address this issue.
Written by:
Zhou L, Cai X, Li H, Wang KJ. Are you the author?
Guo xue xiang 37ChengduSichuanChengDu, China.
Reference: J Endourol. 2014 Dec 10. Epub ahead of print.
doi: 10.1089/end.2014.0715
PubMed Abstract
PMID: 25491604