The Efficacy of Antimuscarinics Alone or in Combination with Alpha-Blockers for the Treatment of Ureteral Stent-Related Symptoms: A Systematic Review and Meta-Analysis

<b><i>Introduction and Aim:</i></b> The purpose of this meta-analysis was to evaluate the efficacy of antimuscarinics alone or in combination with alpha-blockers for the treatment of ureteral stent-related symptoms. <b><i>Methods:</i></b> The databases MEDLINE, EMBASE, PubMed, the Cochrane Controlled Trial Register of Controlled Trials from 2000 to February 2016 were searched to identify randomized controlled trials that referred to the use of a combination of antimuscarinics and alpha-blockers for the treatment of ureteral stent-related symptoms. A systematic review and meta-analysis was conducted. <b><i>Results:</i></b> Seven publications involving 710 patients were included in the meta-analysis. In the analysis, we found significantly improved total International Prostate Symptom Score, quality of life, body pain and work performance score of the Ureteral Stent Symptom Questionnaire (USSQ) in the combination group compared with antimuscarinics alone (p = 0.00001, p = 0.00001, p = 0.00001 and p = 0.004, respectively). Antimuscarinics alone versus the control group showed significant improvement in urinary symptom, body pain and general health score of USSQ (p = 0.002, p = 0.00001 and p = 0.003, respectively). <b><i>Conclusions:</i></b> Our meta-analysis shows the beneficial effect of antimuscarinics alone in reducing stent-related symptoms. The combined use of antimuscarinics and alpha-blockers results in additive favorable effects in patients with ureteral stent-related symptoms compared with antimuscarinics monotherapy. The alpha-blockers may enhance the efficacy of the antimuscarinics, which is beneficial for the treatment of ureteral stent-related symptoms.