Mirabegron for the Treatment of Ureteral Stent-related Symptoms: A Systematic Review and Meta-analysis

Context Ureteral stent-related symptoms (SRSs) are very common and may potentially influence the quality of life and functional capacity of patients. It remains unclear whether mirabegron has a place in the treatment of SRSs. Objective To summarize the evidence of mirabegron for the treatment for SRSs in adult patients. Evidence acquisition A systematic review of literature was performed using the PubMed, Embase, and Google Scholar databases. Studies published up to June 2021 that met the search terms (“mirabegron” OR “B3-agonist”) AND (“stent-related symptoms” OR “stent-related discomfort” OR “stent”) were considered. References from relevant sources were examined to identify additional sources for this review. Relevant studies were selected according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The revised Cochrane tool “RoB 2” was used to assess the quality of included randomized clinical trials. Evidence synthesis Eight studies were selected for final quantitative and qualitative synthesis. The Ureteral Stent Symptom Questionnaire (USSQ) body pain score was significantly improved by mirabegron in five studies, although a pooled data analysis did not reveal any significant changes. The USSQ urinary symptom score was significantly improved by mirabegron in four independent studies as well as in the corresponding meta-analysis, while no changes were found in two studies. International Prostate Symptom Score was improved significantly by mirabegron in three independent studies as well as in the corresponding meta-analysis. The USSQ general health and the quality of life score were improved significantly by mirabegron on meta-analysis. Conclusions Mirabegron may have a beneficial effect on pain and urinary symptoms due to ureteral stents, although the evidence is based on low-quality studies. Patient summary In this report, we looked at the evidence of mirabegron for the treatment of ureteral stent-related symptoms. We found that mirabegron can potentially alleviate pain and bothersome urinary symptoms due to ureteral stents.