Dataset Information

PRISMA-combined ?-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis.

ABSTRACT:

Background

As a monotherpay, a-blockers and anti-muscarinics are both efficacy for ureteral stent-related symptoms (SRS). The aim of the study was to systematically evaluate their efficacy of a combination therapy for SRS.

Methods

Relevant studies investigating ?-blockers and/or anti-muscarinics for SRS were identified though searching online databases including PubMed, EMBASE, Cochrane Library, and other sources up to March 2016. The RevMan software was used for data analysis, and senesitivity analysis and inverted funnel plot were also adopted.

Results

Seven randomized controlled trials (RCTs) and 1 prospective controlled trial including 545 patients were selected. Compared with ?-blockers, the combination group achieved significant improvements in total International Prostate Symptom Score (IPSS) [-3.93 (2.89, 4.96), P?ConclusionsCurrent analysis shows significant advantages of combination therapy compared with monotherapy of ?-blockers or antimuscarinics alone mainly based on IPSS. More RCTs adopting validated USSQ as outcome measures are warranted to support the finding.

SUBMITTER: Zhang YM

PROVIDER: S-EPMC5319511 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Publications

PRISMA-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis.

Zhang Yu-Ming YM Chu Pei P Wang Wen-Jin WJ

Medicine 20170201 7

<h4>Background</h4>As a monotherpay, a-blockers and anti-muscarinics are both efficacy for ureteral stent-related symptoms (SRS). The aim of the study was to systematically evaluate their efficacy of a combination therapy for SRS.<h4>Methods</h4>Relevant studies investigating α-blockers and/or anti-muscarinics for SRS were identified though searching online databases including PubMed, EMBASE, Cochrane Library, and other sources up to March 2016. The RevMan software was used for data analysis, an ...[more]

PMID: 28207522

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Project description:IntroductionWe aimed to assess the effects of postoperative ureteral stent placement after uncomplicated ureteroscopy.MethodsWe performed a comprehensive search with no restrictions on publication language or status up to February 1, 2019. We only included randomized trials. Two review authors independently examined full-text reports, identified relevant studies, assessed the eligibility of studies for inclusion, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and assessed the certainty of the evidence according to GRADE.ResultsWe included 23 studies with 2656 randomized patients. Primary outcomes: It is uncertain whether stenting reduces the number of unplanned return visits (very low certainty of evidence [CoE]). Pain on the day of surgery is probably similar (mean difference [MD] 0.32; 95% confidence interval (CI) -0.13-0.78; moderate CoE). Pain on postoperative days 1-3 may show little to no difference (standardized mean difference [SMD] 0.25; 95% CI -0.32-0.82; low CoE). It is uncertain whether stented patients experience more pain on postoperative days 4-30 (very low CoE). Stenting may result in little to no difference in the need for secondary interventions (risk ratio [RR] 1.15; 95% CI 0.39-3.33; low CoE).Secondary outcomesWe are uncertain whether stenting reduces the need for narcotics and reduces ureteral stricture rates up to 90 days (very low CoE). Rates of hospital admission may be slightly reduced (RR 0.70; 95% CI 0.32-1.55; low CoE). This review was limited to patients in whom ureteroscopy was deemed 'uncomplicated.' In addition, time intervals for the grouping for the reported degree of pain were established post-hoc. The CoE for most outcomes was rated as low or very low for methodological reasons.ConclusionsFindings of this review illustrate the tradeoffs of risks and benefits faced by urologists and their patients when it comes to decision-making about stent placement after uncomplicated ureteroscopy for stone disease.