Comparison of Alpha-Blockers and Antimuscarinics in Improving Ureteral Stent-Related Symptoms: A Meta-Analysis.

PURPOSE: A meta-analysiswas conducted to compare alpha-blocker (AB) and antimuscarinic (AM) monotherapies in releasing US-related symptoms.

METHODS

A comprehensive literature search was performed on online databases PubMed, Web of Science, Med-line, and Cochrane library. Ureteric Symptom Score Questionnaire (USSQ), International Prostate Symptom Score (IPSS), quality of life (QoL) and visual analogue pain scale (VAPS) were pooled and compared.

RESULTS

Nine full-text articles met the inclusion criteria and have been included. The studies were conducted in 9 different centers between 2009 and 2016. All articles were RCT studies and a total of 654 patients were recorded totally, among which 323 were given alpha-blockers while others were given antimuscarinics. Although patients using alpha-blockers presented lower USSQ scores, no statistically significant difference was recorded in urinary symptom(SMD 0.5, 95 % CI -0.2 to 1.20, P = 0.159), pain(SMD 0.33, 95 % CI -0.26 to 0.92, P = 0.280),general health, work performance(SMD-0.34, 95 % CI -0.08 to 0.76, P = 0.115) and sexual performance (all p > 0.05) (SMD 0.12, 95 % CI -0.10 to 0.34, P = 0.280). Meanwhile IPSS (SMD -0.10, 95 % CI -0.32 to 0.11, P = 0.358), QoL(SMD-0.03, 95 % CI -0.23 to 0.18, P = 0.802) and VAPS(SMD 0.08, 95 % CI -0.15 to 0.31, P = 0.447) were similar between the two groups (all P > 0.05).

CONCLUSION

The analysis suggests that AB showed a similar effect with AM. It is necessary to conduct a larger and more detailed cohort study and find the population that potentially might benefit most by AM.