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Combination of solifenacin and tamsulosin may provide additional beneficial effects for ureteral stent-related symptoms—outcomes from a network meta-analysis

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Abstract

Purpose

To systematically evaluate the different efficacy among generally used drugs for stent-related symptoms (SRS) with the method of network meta-analysis.

Methods

A systematic search was performed in the US National Library of Medicine’s life science database (Medline), Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database for Systematic Reviews before December 2017. Analysis was performed under multivariate random-effects network model and effects of drugs were ranked with surface under the cumulative ranking (SUCRA) probabilities.

Results

19 trials with 2036 patients investigating 4 different intervention including tamsulosin (Tam), alfuzosin (Alfu), solifenacin (Soli) and combination of Tam and Solif were finally included in our analysis. Tam plus Soli had the highest SUCRA on all aspects of ureteral stent symptom questionnaire: urinary symptoms (86.2%), body pain (85.0%), general health (80.5%), work performance (72.0%) and sexual performance (84.4%). Except for pain relief, Soli showed higher SUCRA than Tam or Alfu in rest respects. Tam and Alfu showed similar SUCRA on urinary symptoms (53.0 vs 48.7%) and body pain relief (61.9 vs 62.9%).

Conclusions

Tam plus Soli might be the most effective intervention for SRSs. As for monotherapy, Soli showed advantages in most respects except for pain relief compared to Tam or Alfu. Tam and Alfu showed similar efficacy on urinary symptoms and body pain relief.

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Acknowledgements

This article is supported by grants from 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZY2016104), Project of the Health and Family Planning Committee of SichuanProvince, The popularization and promotion of ureteroscopic technique in the treatment of upper urinary tract stones in primary hospitals (16PI294) and Project of Science and Technology Department of Chengdu, Research and application of urogenital suspension mesh (2016-HM02-00020-SF).

Funding

This article is supported by grants from 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZY2016104), Project of the Health and Family Planning Committee of SichuanProvince, The popularization and promotion of ureteroscopic technique in the treatment of upper urinary tract stones in primary hospitals (16PI294) and Project of Science and Technology Department of Chengdu, Research and application of urogenital suspension mesh (2016-HM02-00020-SF).

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Author notes

  1. Zhongyu Jian and Yuntian Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People’s Republic of China

    Zhongyu Jian, Yuntian Chen, Qinyu Liu, Banghua Liao, Tongxin Yang, Hong Li & Kunjie Wang

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  1. Zhongyu Jian
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  2. Yuntian Chen
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  3. Qinyu Liu
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  6. Hong Li
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  7. Kunjie Wang
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Contributions

JZ and CY: project development, data collection and management, manuscript writing and revising; LQ: data collection, data analysis; LB and YT: data collection, data analysis; LH: data collection, data analysis; WK: project design and development, data interpretation, manuscript editing and revising. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kunjie Wang.

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The authors of this article as well as all the included studies declare that they have no conflict of interest.

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The study protocol is compliant with ethical standards.

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Jian, Z., Chen, Y., Liu, Q. et al. Combination of solifenacin and tamsulosin may provide additional beneficial effects for ureteral stent-related symptoms—outcomes from a network meta-analysis. World J Urol 37, 289–297 (2019). https://doi.org/10.1007/s00345-018-2404-6

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  • DOI: https://doi.org/10.1007/s00345-018-2404-6

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