Mirabegron vs. solifenacin in control of endoscopically inserted ureteral stent-related symptoms

Abdelaziz, Alsayed Saad; Salama, Nashaat M.; Ghoneem, Ayman M

doi:10.1007/s00345-022-04068-2

Cited by 5 publications

(10 citation statements)

References 14 publications

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“… Abdelaziz et al (2022 ) and Sahin et al (2020 ) have reported on the IPSS; however, the follow-up times of the two articles differ (2 weeks and 6 weeks, respectively). The results exposed that the IPSS did not differ significantly between the mirabegron and antimuscarinic groups (MD −0.74, 95% CI −1.79 to 0.32, p = 0.17) ( Figure 5 ).…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Lu,

Li,

Zou

et al. 2023

Front. Pharmacol.

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Objective: We conducted a meta-analysis to assess the efficacy and safety of mirabegron (50 mg/day) and antimuscarinics in treating ureteral stent-related symptoms (SRSs).Methods: All randomized controlled trials (RCTs) were identified by searching PubMed, Embase, Web of Science, and Cochrane Library. The RevMan version 5.3.0 software was used for statistical analysis.Results: This meta-analysis included five RCTs involving 317 patients. A fixed effects model revealed that mirabegron was superior to antimuscarinics in treating urinary symptoms (MD −1.39, 95% CI −2.63 to −0.15, p = 0.03) and general health (MD −1.65, 95% CI −2.60 to −0.69, p = 0.0007) 1 week after treatment initiation. We observed no significant differences in body pain (MD 0.05, 95% CI −1.06 to 1.15, p = 0.94), work performance (MD −0.86, 95% CI −1.77 to 0.06, p = 0.07), and sexual matters (MD 0.03, 95% CI −0.77 to 0.83, p = 0.94). Two weeks after treatment initiation, the ureteral stent symptom questionnaire (USSQ) revealed no significant differences between the two groups. The mirabegron group demonstrated a significant improvement in the quality of life (QoL) (MD −0.18, 95% CI −0.34 to −0.01, p = 0.03), while the International Prostate Symptom Score did not reveal a significant difference between the two groups (MD −0.74, 95% CI −1.79 to 0.32, p = 0.17). Regarding safety, a pooled data analysis presented that the incidence of constipation was lower in the mirabegron group (OR 0.10, 95% CI 0.01 to 0.77, p = 0.03). The mirabegron and antimuscarinics groups did not differ significantly concerning the risk of dry mouth (OR 0.15, 95% CI 0.02 to 1.27, p = 0.08).Conclusion: Mirabegron is superior to antimuscarinics in alleviating ureteral SRSs and improving QoL. Additionally, mirabegron 50 mg/day presented safety with a lower incidence of constipation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

Lu,

Li,

Zou

et al. 2023

Front. Pharmacol.

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“…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).…”

Section: Resultsmentioning

confidence: 99%

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

2023

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Purpose: Ureteral stents are commonly used for the treatment of ureteral obstruction, most often urolithiasis. Their use may be associated with significant bothersome symptoms and discomfort. Prior studies have examined the effects of various medication regimens on ureteral stent symptoms. This study utilized Bayesian network meta-analysis to analyze all available evidence on the pharmacological management of ureteral stenterelated symptoms. Materials and Methods: In December 2022 a systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Metaanalyses) guidelines on randomized prospective studies on pharmacological management of ureteral stenterelated symptoms reporting outcomes using the Ureteral Stent Symptom Questionnaire score on urinary symptoms and pain. The data were analyzed in Review Manager 5.3 and R Studio where a Bayesian network metaanalysis was performed. Treatments were ranked using surface under the cumulative ranking curve and mean difference vs placebo with 95% credible intervals. Results: A total of 26 studies were analyzed. These were used to build networks which were modeled to run 100,000 Markov Chain Montecarlo simulations each. Drug-class analysis revealed the most effective class for each domain: for urinary symptoms, sexual performance, general health, and work performancedcombined a-blocker and anticholinergic and phosphodiesterase 5 inhibitors; for paindcombined anticholinergic and pregabalin. The following were the most effective drugs and dosages for specific symptoms: for urinary symptomsdcombined silodosin 8 mgDsolifenacin 10 mg; for paindcombined silodosin 8 mgDsolifenacin 10 mg; for sexual performancedtadalafil 5 mg. Combined silodosin 8 mgDsolifenacin 10 mgDtadalafil 5 mg has the best general health scores while solifenacin 10 mg had the best work experience scores. Conclusions: This network meta-analysis demonstrated that the most effective drug therapy is different for each symptom domain. It is important to consider a patient's chief complaint and domains in order to ascertain the optimal medication regimen for each patient. Further iterations of this analysis can be strengthened by trials that directly compare more of these drugs instead of relying on indirect evidence.

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“…The recovery period will be more uncomfortable because the D-J stent is generally in left position for 2-4 weeks in the clinic [18]. The symptoms associated to ureteral stent-related occurred frequently, and the main symptoms, which include body discomfort, lower urinary symptoms, and hematuria, and all have a negative impact on the patients' quality of life [19,20]. In this work, grade-1 ureteral injury required the retention of D-J stents for a month in two cases, and for the second stage operation in one case because no stones identi ed during the operation.…”

Section: Discussionmentioning

confidence: 99%

Outcome of combining 7.5Fr disposable electronic flexible ureteroscope with 10Fr ureteral access sheath in the treatment of renal stones < 2cm: initial experience

Song

Cheng

Xie

et al. 2023

Preprint

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Purpose: To evaluate the effectiveness and safety of combining 7.5Fr flexible ureteroscope with 10Fr ureteral access sheath performed in patients with renal calculi under 2cm. Materials and methods: We prospectively involved 10 patients with renal calculi < 2cm who underwent holmium laser lithotripsy using the combination of 7.5Fr flexible ureteroscope and a 10Fr ureteral access sheath without double-J stents pre-reserved. The patients’ profiles, including preoperative, operative information, and postoperative complications, were recorded. Results: The success rate of sheath placement was 100% with the operation time of 55.0 ± 20.0 min, while the lithotripsy time of 150.4 ± 199.0 s. Due to the grade-1 injury of ureter, the double-J stent was retained in two cases for a month. Moreover, the duration of stent-keeping was 18.3 ± 20.13 hours, the hospitalization duration after operation was 45.6 ± 15.5 h, and the pain score after 24 hours postoperatively was 4.3 ± 3.5, respectively. Hemoglobin decreased by 5.0 ± 9.2 g/L and creatinine increased by 1.9 ± 6.6 μmol/L postoperatively, and none of the patients suffered from fever or hemorrhage. The SFR was 90.0% in a month after surgery. In terms of the symptom score of stents, overactive bladder symptom score was 1.7 ± 1.5, international prostate symptom score of 3.3 ± 2.8, and quality of life of 1.3 ± 1.7. Conclusion: Combining 7.5Fr flexible ureteroscope with 10Fr ureteral access sheath is recommended as a safe option for treating renal calculi < 2cm with high rate of sheath placement and lower rate of complication.

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Mirabegron vs. solifenacin in control of endoscopically inserted ureteral stent-related symptoms

Cited by 5 publications

References 14 publications

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

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

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

Outcome of combining 7.5Fr disposable electronic flexible ureteroscope with 10Fr ureteral access sheath in the treatment of renal stones < 2cm: initial experience

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Mirabegron vs. solifenacin in control of endoscopically inserted ureteral stent-related symptoms

Cited by 5 publications

References 14 publications

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

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

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

Outcome of combining 7.5Fr disposable electronic flexible ureteroscope with 10Fr ureteral access sheath in the treatment of renal stones &lt; 2cm: initial experience

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Outcome of combining 7.5Fr disposable electronic flexible ureteroscope with 10Fr ureteral access sheath in the treatment of renal stones < 2cm: initial experience