Department of Urology, Panzhihua Central Hospital, 34 Yikang Street, Panzhihua Avenue, Dong District, Panzhihua, 617067, China.
Department of Geriatrics, Panzhihua Central Hospital, Panzhihua, China.
World J Urol. 2017 Nov;35(11):1669-1680. doi: 10.1007/s00345-017-2051-3. Epub 2017 May 26.
Ureteral stenting is associated with various morbidity and reduced quality of life. We systematically evaluated the efficacy and safety of solifenacin as monotherapy, or combined therapy with tamsulosin versus control or tamsulosin monotherapy in stent-related symptoms (SRSs).
Randomized controlled trials evaluating solifenacin or its combination with tamsulosin for the treatment of SRSs were identified via a comprehensive search of Pubmed, Embase, Ovid, The Cochrane Library and relevant sources up to February 2017. Ureteral stent symptom questionnaire (USSQ) and drug-related complications were pooled for meta-analysis. Mean difference and risk difference were calculated as appropriate for each outcome to determine the cumulative effect size.
There were 10 studies involving 1786 participants finally eligible in the quantitative analysis. Solifenacin monotherapy significantly reduced the total score of USSQ [MD -14.90; 95% CI (-25.19, -4.60); P = 0.005], as well as indexes of urinary symptoms, body pain, general health, sexual performance, and hematuria (P = 0.02, P = 0.009, P = 0.004, P = 0.02, P = 0.02, respectively), but the differences were insignificant when compared with tamsulosin except improved sexual performance (P = 0.004). Combined therapy of solifenacin and tamsulosin showed no beneficial effects in all indexes of USSQ over solifenacin monotherapy. Only slightly higher incidence of dry mouth (P = 0.02) was found with solifenacin versus control.
The result demonstrates the safety and efficacy of solifenacin in reducing SRSs, but no significant advantage was found over tamsulosin. In addition, combination of solifenacin and tamsulosin did not show beneficial effects over solifenacin monotherapy. More high quality trials are warranted to further address this issue, however.
输尿管支架置入相关的各种发病率和降低生活质量。我们系统地评估索利那新作为单一疗法，或与坦索罗辛联合治疗支架相关症状（SRSs）的疗效和安全性。
通过全面检索 Pubmed、Embase、Ovid、The Cochrane Library 和相关来源，确定了评价索利那新或其与坦索罗辛联合治疗 SRSs 的随机对照试验，检索时间截至 2017 年 2 月。对输尿管支架症状问卷（USSQ）和药物相关并发症进行荟萃分析。适当计算每个结局的均数差和风险差，以确定累积效应量。
共有 10 项研究，涉及 1786 名符合条件的参与者，最终纳入定量分析。索利那新单药治疗可显著降低 USSQ 的总分[MD -14.90；95%CI（-25.19，-4.60）；P = 0.005]，以及尿症状、身体疼痛、一般健康、性功能和血尿的指标（P = 0.02，P = 0.009，P = 0.004，P = 0.02，P = 0.02），但与坦索罗辛相比，除了性功能改善外，差异均无统计学意义（P = 0.004）。索利那新联合坦索罗辛治疗在 USSQ 的所有指标中均未显示出优于索利那新单药的有益效果。与对照组相比，仅发现索利那新组口干的发生率略高（P = 0.02）。
结果表明索利那新可安全有效地减轻 SRSs，但与坦索罗辛相比无显著优势。此外，索利那新联合坦索罗辛治疗与索利那新单药治疗相比没有显示出有益效果。需要更多高质量的试验来进一步解决这个问题。
