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The beneficial effect of alpha-blockers for ureteral stent-related discomfort: systematic review and network meta-analysis for alfuzosin versus tamsulosin versus placebo

 Jong Kyou Kwon  ;  Kang Su Cho  ;  Cheol Kyu Oh  ;  Dong Hyuk Kang  ;  Hyungmin Lee  ;  Won Sik Ham  ;  Young Deuk Choi  ;  Joo Yong Lee 
 BMC UROLOGY, Vol.15 : 55, 2015 
Journal Title
Issue Date
Adrenergic alpha-Antagonists/administration & dosage* ; Bayes Theorem ; Humans ; Pain/drug therapy* ; Pain/etiology ; Pain Measurement ; Quinazolines/administration & dosage* ; Randomized Controlled Trials as Topic ; Stents/adverse effects* ; Sulfonamides/administration & dosage* ; Treatment Outcome ; Ureteral Obstruction/diagnosis ; Ureteral Obstruction/therapy
Ureter ; Stents ; Adrenergic alpha-antagonists ; Meta-analysis ; Bayes theorem
BACKGROUND: This study was carried out a network meta-analysis of evidence from randomized controlled trials (RCTs) to evaluate stent-related discomfort in patients with alfuzosin or tamsulosin versus placebo. METHODS: Relevant RCTs were identified from electronic databases. The proceedings of appropriate meetings were also searched. Seven articles on the basis of RCTs were included in our meta-analysis. Using pairwise and network meta-analyses, comparisons were made by qualitative and quantitative syntheses. Evaluation was performed with the Ureteric Stent Symptoms Questionnaire to assess the urinary symptom score (USS) and body pain score (BPS). RESULTS: One of the seven RCTs was at moderate risk of bias for all quality criteria; two studies had a high risk of bias. In the network meta-analysis, both alfuzosin (mean difference [MD];-4.85, 95 % confidence interval [CI];-8.53--1.33) and tamsulosin (MD;-8.84, 95 % CI;-13.08--4.31) showed lower scores compared with placebo; however, the difference in USS for alfuzosin versus tamsulosin was not significant (MD; 3.99, 95 % CI;-1.23-9.04). Alfuzosin (MD;-5.71, 95 % CI;-11.32--0.52) and tamsulosin (MD;-7.77, 95 % CI;-13.68--2.14) showed lower scores for BPS compared with placebo; however, the MD between alfuzosin and tamsulosin was not significant (MD; 2.12, 95 % CI;-4.62-8.72). In the rank-probability test, tamsulosin ranked highest for USS and BPS, and alfuzosin was second. CONCLUSION: The alpha-blockers significantly decreased USS and BPS in comparison with placebo. Tamsulosin might be more effective than alfuzosin.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
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