Mirabegron as effective as oxybutynin for ureteral stent symptoms

Abstract

OBJECTIVE: Ureteral stents usually cause pain and lower urinary tract discomfort. This study aimed to compare the effect of mirabegron with oxybutynin in relieving ureteral stent-related symptoms over time.METHODS: A prospective, longitudinal, randomized, single-blinded study was conducted. Patients who had a ureteral stent inserted after urolithiasis treatment were classified into two groups and received either oxybutynin 5 mg/day (Group O) or mirabegron 50 mg/ day (Group M). The Ureteral Stent Symptoms Questionnaire (USSQ) was applied on the 3rd, 6th, and 15th postoperative days. Group domain scores were compared, and a mixed linear model was used to better assess score differences.RESULTS: Ureteral Stent Symptoms Questionnaire scores were similar in both groups during all three postoperative days (p>0.05).A longitudinal analysis showed that global quality of life and general health improved over time, independently of the use of any of the medications (p<0.05), while urinary symptoms and body pain scores were lower over time in participants receiving oxybutynin.CONCLUSION: Both mirabegron and oxybutynin are equivalent in relieving ureteral stent symptoms. Moreover, some stent symptoms seem to decrease over time despite the use of medication.

Pharmacological Management of Ureteral Stent–related Symptoms: A Systematic Review, Bayesian Network Meta-analysis, and Meta-regression

“…A total of 2,900 patients from 26 studies were included. 8,9,21-44 Of these, 992 received placebo, 601 received α-blockers, 534 anticholinergics, 192 β-3-agonists, 145 combined α-blockers and anticholinergics, 131 PDE5i, 188 pregabalin, 186 combined anticholinergics and pregabalin, 41 combined α-blockers with PDE5i, 42 combined anticholinergics with PDE5i, and 40 combined α-blockers, anticholinergics, and PDE5i. Summary of included studies is displayed in Supplemental Table 1 (https://www.jurology.com).…”

Mirabegron and antimuscarinics for treating ureteral stent-related symptoms: a systematic review and meta-analysis of RCTs

“…We finally identified five RCTs ( Palinggi et al, 2020 ; Sahin et al, 2020 ; Jaworski et al, 2021 ; Abdelaziz et al, 2022 ; Chandna et al, 2022 ) in this meta-analysis through database search: three RCTs compared the effects of mirabegron and solifenacin ( Palinggi et al, 2020 ; Abdelaziz et al, 2022 ; Chandna et al, 2022 ); one compared the effects of mirabegron and oxybutynin ( Jaworski et al, 2021 ); and another compared the effects of mirabegron and a combination of solifenacin and tamsulosin ( Sahin et al, 2020 ). Table 1 lists the primary characteristics of the included studies.…”

“…Four RCTs ( Palinggi et al, 2020 ; Jaworski et al, 2021 ; Abdelaziz et al, 2022 ; Chandna et al, 2022 ) designed multiple follow-up visits on the USSQ to study SRSs. The measured time point of the questionnaire ranged from 3 days to 6 weeks.…”

“…Three studies ( Palinggi et al, 2020 ; Jaworski et al, 2021 ; Chandna et al, 2022 ) that enrolled 171 participants (85 in the mirabegron group and 86 in the antimuscarinics group) analyzed the USSQ at week 1. A fixed effects model revealed that mirabegron significantly reduced urinary symptoms (MD −1.39, 95% CI −2.63 to −0.15, p = 0.03) and improved general health (MD −1.65, 95% CI −2.60 to −0.69, p = 0.0007) ( Figures 3A, C ).…”

“… Jaworski et al (2021 ) and Abdelaziz et al( 2022 ) reported the QoL score and all the questionnaires were conducted at 2 weeks. The fixed effects model–pooled results disclosed that mirabegron significantly improved the QoL (MD −0.18, 95% CI −0.34 to −0.01, p = 0.03) ( Figure 6 ).…”