α₁-blockers for the reduction of ureteric stent-related symptoms: A systematic review and meta-analysis

The present meta-analysis aimed to evaluate the current evidence for the use of α₁-blockers in relieving ureteric stent-related symptoms (USS). Electronic databases, including PubMed, Embase and Cochrane Library, were searched and two independent reviewers identified relevant parallel randomized controlled trials (RCTs), assessed trial quality and extracted data. Review Manager (version 5.2) was used to conduct a meta-analysis of the data. Significant advantages were demonstrated in the treatment group based on International Prostate Symptom Score (IPSS), voiding symptom sub-scores [mean difference (MD), -2.66; 95% confidence interval (CI), (-4.36, -0.96)], Ureteral Stent Symptom Questionnaire (USSQ) urinary symptoms score (MD, -5.84; 95%CI, -9.35 to -2.33), IPSS quality of life score (MD, -1.46; 95%CI, -2.64 to -0.28) USSQ quality of life score (MD, -0.69; 95%CI, -1.10 to -0.28), USSQ pain score (MD, -3.97; 95%CI, -5.52 to -2.42), Visual Analog Pain Scale (MD, -1.53; 95%CI, -2.25 to -0.80) and USSQ general health score (MD, -1.82; 95%CI, -2.47 to -1.18). No significant differences were detected from the following results: IPSS storage symptom sub-score (MD, -0.93; 95%CI, -2.28 to 0.43), USSQ sexual matters score (MD, -0.10; 95%CI, -0.79 to 0.59), USSQ work performance score (MD, 1.64; 95%CI, -2.18 to 5.47) and USSQ additional problems score (MD, -2.02; 95%CI, -4.55 to 0.52). However, significant between-trial heterogeneity was detected following statistical analysis and there were insufficient data to trace its source. The existing RCT data supported the hypothesis that α₁-blockers beneficially influence pain, urinary symptoms and the quality of life of patients with an indwelling ureteral stent.