Effects of α-Blockers, Antimuscarinics, or Combination Therapy in Relieving Ureteral Stent-Related Symptoms: A Meta-Analysis

Zhou, Liang; Cai, Xiang; Li, Hong; Wang, Kun‐Jie

doi:10.1089/end.2014.0715

Cited by 65 publications

(61 citation statements)

References 34 publications

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“…[17][18][19] These trials were summarized in a meta-analysis by Zhou et al in 2015. 20 The authors concluded that antimuscarinics alone improve IPSS total score as well as QoL and VAPS, and that combination therapy with a 1 -blockers seems to be superior compared with the respective monotherapies. However, because of limited data, heterogeneity between the trials (i.e.…”

Section: Antimuscarinicsmentioning

confidence: 98%

Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review

et al. 2017

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Temporary drainage of the upper urinary tract by internal ureteral stents is a routine procedure in endourology. However, it is associated with a clear side-effect profile. Our aim was to evaluate prevention and treatment options of stent-related symptoms. We carried out a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines using MEDLINE and SCOPUS, and identified 107 appropriate records. A high number of these studies showed clear methodological limitations. Available data clearly support the use of a 1 -blockers in patients suffering from stent-related symptoms. It seems that antimuscarinic monotherapy or combination with a 1 -blockers might also play an important role, whereas the use of classical analgesics in the treatment of stent-related symptoms has not been assessed systematically within clinical trials so far. Improvements in stent design and material seem to have the potential to reduce stent-related symptoms. However, so far there is no type of stent with outstanding characteristics and clear evidence suggesting fundamental advantages compared with a standard double pigtail stent. Although stent diameter does not seem to influence patients' comfort, it seems to be beneficial to choose a proper stent-length. Coated and drug-eluting stents, as well as intravesical drug application, seem to be promising concepts to prevent stent-related symptoms, but still have to be considered as experimental approaches. Furthermore, thorough patient education has the potential to reduce the morbidity associated with ureteral stenting. Further research in the field seems to be mandatory.

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Section: Antimuscarinicsmentioning

confidence: 98%

Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review

et al. 2017

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“…Alpha-blockers may relax the prostate smooth muscle, the bladder neck and the distal ureter smooth muscle to decrease bladder outlet resistance and voiding pressure, thus explaining the beneficial effects on stent-related LUTS [29] . Antimuscarinics have been thought to block muscarinic receptors on the efferent in the detrusor muscle and reduce the involuntary bladder contraction caused by trigone irritation, thus alleviating the stent-induced OAB symptoms [12] .…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a meta-analysis has found that the antimuscarinics alone are superior to placebo according to International Prostate Symptom Score (IPSS) and QoL scores. Besides, the combination therapy is superior to monotherapy with alpha-blockers in treatment of patients with ureteral stent symptoms [12] .…”

mentioning

confidence: 99%

The Efficacy of Antimuscarinics Alone or in Combination with Alpha-Blockers for the Treatment of Ureteral Stent-Related Symptoms: A Systematic Review and Meta-Analysis

Yan¹,

Wang²,

Sun³

et al. 2016

Urol Int

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Introduction and Aim: The purpose of this meta-analysis was to evaluate the efficacy of antimuscarinics alone or in combination with alpha-blockers for the treatment of ureteral stent-related symptoms. Methods: The databases MEDLINE, EMBASE, PubMed, the Cochrane Controlled Trial Register of Controlled Trials from 2000 to February 2016 were searched to identify randomized controlled trials that referred to the use of a combination of antimuscarinics and alpha-blockers for the treatment of ureteral stent-related symptoms. A systematic review and meta-analysis was conducted. Results: Seven publications involving 710 patients were included in the meta-analysis. In the analysis, we found significantly improved total International Prostate Symptom Score, quality of life, body pain and work performance score of the Ureteral Stent Symptom Questionnaire (USSQ) in the combination group compared with antimuscarinics alone (p = 0.00001, p = 0.00001, p = 0.00001 and p = 0.004, respectively). Antimuscarinics alone versus the control group showed significant improvement in urinary symptom, body pain and general health score of USSQ (p = 0.002, p = 0.00001 and p = 0.003, respectively). Conclusions: Our meta-analysis shows the beneficial effect of antimuscarinics alone in reducing stent-related symptoms. The combined use of antimuscarinics and alpha-blockers results in additive favorable effects in patients with ureteral stent-related symptoms compared with antimuscarinics monotherapy. The alpha-blockers may enhance the efficacy of the antimuscarinics, which is beneficial for the treatment of ureteral stent-related symptoms.

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“…However, its placement results in different symptoms resulting in poor quality of patients' life. DJ stent is associated with different ureteral stent related symptoms like frequency, urgency, flank pain, suprapubic pain and hematuria 4,5 . The incidence varies from 19 -76% [6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Role of Alfuzosin in Ureteral Stent Related Urinary Symptoms Score: A Comparative Study

Shrestha

Adhikari

Gurung

et al. 2017

J. Gandaki Med. Coll. Nepal

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Effects of α-Blockers, Antimuscarinics, or Combination Therapy in Relieving Ureteral Stent-Related Symptoms: A Meta-Analysis

Cited by 65 publications

References 34 publications

Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review

Prevention and treatment of symptoms associated with indwelling ureteral stents: A systematic review

The Efficacy of Antimuscarinics Alone or in Combination with Alpha-Blockers for the Treatment of Ureteral Stent-Related Symptoms: A Systematic Review and Meta-Analysis

Role of Alfuzosin in Ureteral Stent Related Urinary Symptoms Score: A Comparative Study

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