The Beneficial Effects of Alpha-Blockers, Antimuscarinics, Beta 3-Agonist, and PDE5-Inhibitors for Ureteral Stent-Related Discomfort: A Systematic Review and Meta-Analysis from KSER Update Series
<i>Background and Objectives</i>: Ureteral stents are widely used in the field of urology but can cause varying degrees of side effects. This study utilized a network meta-analysis to evaluate stent-related discomfort (SRD) in patients with alpha-blockers (alfuzosin, tamsulosin, and silo...
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2025-01-01
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| author | Young Joon Moon Doo Yong Chung Do Kyung Kim Hae Do Jung Seung Hyun Jeon Seok Ho Kang Sunghyun Paick Joo Yong Lee |
| author_facet | Young Joon Moon Doo Yong Chung Do Kyung Kim Hae Do Jung Seung Hyun Jeon Seok Ho Kang Sunghyun Paick Joo Yong Lee |
| author_sort | Young Joon Moon |
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| description | <i>Background and Objectives</i>: Ureteral stents are widely used in the field of urology but can cause varying degrees of side effects. This study utilized a network meta-analysis to evaluate stent-related discomfort (SRD) in patients with alpha-blockers (alfuzosin, tamsulosin, and silodosin), antimuscarinics (solifenacin), beta 3-agonists (mirabegron), and phosphodiesterase 5-inhibitors (tadalafil) versus a placebo. <i>Materials and Methods</i>: Relevant randomized controlled trials (RCTs) from 2006 to 2021 were identified from electronic databases, including PubMed, EMBASE, and the Cochrane Library. The following identifiers were included to assess the urinary symptom score (USS): participants (patients with ureteral stents), interventions (patients who took medication for stent discomfort), and outcomes (comparisons of the Ureteric Stent Symptoms Questionnaire (USSQ)). We also executed an independent quality assessment using the Scottish Intercollegiate Guidelines Network (SIGN). <i>Results</i>: A total of 16 RCTs were identified, and they included 1865 patients. Compared with the placebo, mirabegron (mean difference (MD): −3.87; 95% confidence interval (CI): −10.6–2.35), tadalafil (MD: −4.47; 95% CI: −10.8–1.63), and silodosin (MD: −4.02; 95% CI: −12–4.01) did not show significant differences to the placebo, whereas others did. Alfuzosin, mirabegron, silodosin, solifenacin, and tadalafil were not inferior to tamsulosin in terms of the USS using Bayesian analyses. In the random effect model, P-score tests showed that solifenacin possessed the highest P-score (<i>p</i> = 0.8484); tamsulosin was the second highest (<i>p</i> = 0.7054). As a result of the rank-probability test, solifenacin was also ranked highest in terms of USS, and tamsulosin was ranked second. <i>Conclusions</i>: Compared with the placebo, solifenacin, tamsulosin, and alfuzosin significantly decreased the USS. In our study, solifenacin may be considered the most effective medication for SRD. |
| format | Article |
| id | doaj-art-afe3ca1d0de343b8ba88c939b2e43a15 |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| spelling | doaj-art-afe3ca1d0de343b8ba88c939b2e43a152025-08-20T02:04:06ZengMDPI AGMedicina1010-660X1648-91442025-01-0161223210.3390/medicina61020232The Beneficial Effects of Alpha-Blockers, Antimuscarinics, Beta 3-Agonist, and PDE5-Inhibitors for Ureteral Stent-Related Discomfort: A Systematic Review and Meta-Analysis from KSER Update SeriesYoung Joon Moon0Doo Yong Chung1Do Kyung Kim2Hae Do Jung3Seung Hyun Jeon4Seok Ho Kang5Sunghyun Paick6Joo Yong Lee7Department of Urology, College of Medicine, Ewha Womans University, Seoul 07804, Republic of KoreaDepartment of Urology, Inha University College of Medicine, Incheon 22212, Republic of KoreaDepartment of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Urology, Inje University Ilsan Paik Hospital, College of Medicine, Inje University, Goyang 10380, Republic of KoreaDepartment of Urology, Kyung Hee University School of Medicine, Seoul 02447, Republic of KoreaDepartment of Urology, Korea University College of Medicine, Seoul 02841, Republic of KoreaDepartment of Urology, Konkuk University School of Medicine, Seoul 05030, Republic of KoreaDepartment of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea<i>Background and Objectives</i>: Ureteral stents are widely used in the field of urology but can cause varying degrees of side effects. This study utilized a network meta-analysis to evaluate stent-related discomfort (SRD) in patients with alpha-blockers (alfuzosin, tamsulosin, and silodosin), antimuscarinics (solifenacin), beta 3-agonists (mirabegron), and phosphodiesterase 5-inhibitors (tadalafil) versus a placebo. <i>Materials and Methods</i>: Relevant randomized controlled trials (RCTs) from 2006 to 2021 were identified from electronic databases, including PubMed, EMBASE, and the Cochrane Library. The following identifiers were included to assess the urinary symptom score (USS): participants (patients with ureteral stents), interventions (patients who took medication for stent discomfort), and outcomes (comparisons of the Ureteric Stent Symptoms Questionnaire (USSQ)). We also executed an independent quality assessment using the Scottish Intercollegiate Guidelines Network (SIGN). <i>Results</i>: A total of 16 RCTs were identified, and they included 1865 patients. Compared with the placebo, mirabegron (mean difference (MD): −3.87; 95% confidence interval (CI): −10.6–2.35), tadalafil (MD: −4.47; 95% CI: −10.8–1.63), and silodosin (MD: −4.02; 95% CI: −12–4.01) did not show significant differences to the placebo, whereas others did. Alfuzosin, mirabegron, silodosin, solifenacin, and tadalafil were not inferior to tamsulosin in terms of the USS using Bayesian analyses. In the random effect model, P-score tests showed that solifenacin possessed the highest P-score (<i>p</i> = 0.8484); tamsulosin was the second highest (<i>p</i> = 0.7054). As a result of the rank-probability test, solifenacin was also ranked highest in terms of USS, and tamsulosin was ranked second. <i>Conclusions</i>: Compared with the placebo, solifenacin, tamsulosin, and alfuzosin significantly decreased the USS. In our study, solifenacin may be considered the most effective medication for SRD.https://www.mdpi.com/1648-9144/61/2/232network meta-analysisstentsurolithiasis |
| spellingShingle | Young Joon Moon Doo Yong Chung Do Kyung Kim Hae Do Jung Seung Hyun Jeon Seok Ho Kang Sunghyun Paick Joo Yong Lee The Beneficial Effects of Alpha-Blockers, Antimuscarinics, Beta 3-Agonist, and PDE5-Inhibitors for Ureteral Stent-Related Discomfort: A Systematic Review and Meta-Analysis from KSER Update Series Medicina network meta-analysis stents urolithiasis |
| title | The Beneficial Effects of Alpha-Blockers, Antimuscarinics, Beta 3-Agonist, and PDE5-Inhibitors for Ureteral Stent-Related Discomfort: A Systematic Review and Meta-Analysis from KSER Update Series |
| title_full | The Beneficial Effects of Alpha-Blockers, Antimuscarinics, Beta 3-Agonist, and PDE5-Inhibitors for Ureteral Stent-Related Discomfort: A Systematic Review and Meta-Analysis from KSER Update Series |
| title_fullStr | The Beneficial Effects of Alpha-Blockers, Antimuscarinics, Beta 3-Agonist, and PDE5-Inhibitors for Ureteral Stent-Related Discomfort: A Systematic Review and Meta-Analysis from KSER Update Series |
| title_full_unstemmed | The Beneficial Effects of Alpha-Blockers, Antimuscarinics, Beta 3-Agonist, and PDE5-Inhibitors for Ureteral Stent-Related Discomfort: A Systematic Review and Meta-Analysis from KSER Update Series |
| title_short | The Beneficial Effects of Alpha-Blockers, Antimuscarinics, Beta 3-Agonist, and PDE5-Inhibitors for Ureteral Stent-Related Discomfort: A Systematic Review and Meta-Analysis from KSER Update Series |
| title_sort | beneficial effects of alpha blockers antimuscarinics beta 3 agonist and pde5 inhibitors for ureteral stent related discomfort a systematic review and meta analysis from kser update series |
| topic | network meta-analysis stents urolithiasis |
| url | https://www.mdpi.com/1648-9144/61/2/232 |
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