Improvement in ureteral stent related symptoms with combination therapy

30.07.2018

A combination of the antimuscarinic and the alpha blocker may be the most effective treatment for ureteral stent-related symptoms.

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.

19 trials with 2036 patients investigating 4 different intervention including tamsulosin, alfuzosin, solifenacin and combination of Tam and Solif were finally included in our analysis.

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

Solifenacin and tamsulosin have a "synergistic effect" on stent-related symptoms by concurrently inhibiting receptors on smooth muscle cells in the bladder neck, lower ureter, and detrusor.

Additional studies including other common drugs such as terazosin, doxazosin, and tolterodine are still needed.

Reference

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. DOI: 10.1007/s00345-018-2404-6