Abstract
Purpose:
We evaluated the effects of α-blockers, antimuscarinics, or a 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 of 13 articles were identified including 1408 patients. There were statistically significant differences in urinary symptom (−6.37; P<0.0001) and body pain index score (−7.03; P=0.0008) of the Ureteral 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 the α-blocker group. Antimuscarinics alone vs the control group showed significant improvement in total IPSS (mean difference [MD]: −3.76; 95% confidence interval [CI], −5.08 to −2.43; P<0.00001) and QoL (MD: −0.82; 95% CI, −1.31 to −0.32; P=0.001). Compared with 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 compared with α-blocker monotherapy. However, more high quality, randomized controlled trials are warranted to better address this issue, however.
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