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

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 α-blockers and/or anti-muscarinics f...

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Autores principales: Zhang, Yu-ming, Chu, Pei, Wang, Wen-jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319511/
https://www.ncbi.nlm.nih.gov/pubmed/28207522
http://dx.doi.org/10.1097/MD.0000000000006098
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author Zhang, Yu-ming
Chu, Pei
Wang, Wen-jin
author_facet Zhang, Yu-ming
Chu, Pei
Wang, Wen-jin
author_sort Zhang, Yu-ming
collection PubMed
description 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 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, 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 α-blockers, the combination group achieved significant improvements in total International Prostate Symptom Score (IPSS) [–3.93 (2.89, 4.96), P < 0.00001], obstructive subscore [–1.29 (0.68, 1.89), P < 0.0001], irritative subscore [–2.93 (2.18, 3.68), P < 0.00001], and quality of life score [–0.99 (0.42, 1.55), P < 0.001]. Compared with antimuscarinics, there were also significant differences in total IPSS [–3.49 (2.43, 4.55), P < 0.00001], obstructive subscore [–1.40 (0.78, 2.01), P < 0.00001], irritative subscore [–2.10 (1.30, 2.90), P < 0.00001], and quality of life score [–1.18 (0.58, 1.80), P < 0.001] in favor of combination group. No significant difference was found in the visual analog pain score and the urinary symptoms score in Ureteral Stent Symptom Questionnaire (USSQ). No significant difference in complications was found. CONCLUSIONS: Current analysis shows significant advantages of combination therapy compared with monotherapy of α-blockers or antimuscarinics alone mainly based on IPSS. More RCTs adopting validated USSQ as outcome measures are warranted to support the finding.
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spelling pubmed-53195112017-03-02 PRISMA-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis Zhang, Yu-ming Chu, Pei Wang, Wen-jin Medicine (Baltimore) 7300 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 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, 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 α-blockers, the combination group achieved significant improvements in total International Prostate Symptom Score (IPSS) [–3.93 (2.89, 4.96), P < 0.00001], obstructive subscore [–1.29 (0.68, 1.89), P < 0.0001], irritative subscore [–2.93 (2.18, 3.68), P < 0.00001], and quality of life score [–0.99 (0.42, 1.55), P < 0.001]. Compared with antimuscarinics, there were also significant differences in total IPSS [–3.49 (2.43, 4.55), P < 0.00001], obstructive subscore [–1.40 (0.78, 2.01), P < 0.00001], irritative subscore [–2.10 (1.30, 2.90), P < 0.00001], and quality of life score [–1.18 (0.58, 1.80), P < 0.001] in favor of combination group. No significant difference was found in the visual analog pain score and the urinary symptoms score in Ureteral Stent Symptom Questionnaire (USSQ). No significant difference in complications was found. CONCLUSIONS: Current analysis shows significant advantages of combination therapy compared with monotherapy of α-blockers or antimuscarinics alone mainly based on IPSS. More RCTs adopting validated USSQ as outcome measures are warranted to support the finding. Wolters Kluwer Health 2017-02-17 /pmc/articles/PMC5319511/ /pubmed/28207522 http://dx.doi.org/10.1097/MD.0000000000006098 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 7300
Zhang, Yu-ming
Chu, Pei
Wang, Wen-jin
PRISMA-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis
title PRISMA-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis
title_full PRISMA-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis
title_fullStr PRISMA-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis
title_full_unstemmed PRISMA-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis
title_short PRISMA-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: A meta-analysis
title_sort prisma-combined α-blockers and antimuscarinics for ureteral stent-related symptoms: a meta-analysis
topic 7300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319511/
https://www.ncbi.nlm.nih.gov/pubmed/28207522
http://dx.doi.org/10.1097/MD.0000000000006098
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