A meta-analysis of efficacy and safety of PDE5 inhibitors in the treatment of ureteral stent-related symptoms

• Published in: Annals of palliative medicine Vol. 10; no. 2; pp. 1000 - 1011
• Main Authors: Zhang, Dongxu, Sun, Kai, Wang, Tianqi, Wu, Gang, Wang, Jipeng, Wu, Jitao, Ma, Jian, Cui, Yuanshan
• Format: Journal Article
• Language: English
• Published: China 01.02.2021
• Subjects: Humans; Phosphodiesterase 5 Inhibitors - adverse effects; Stents; phosphodiesterase type 5 inhibitors (PDE5 inhibitors); urinary symptom; randomized controlled trial (RCT); ureteral stent; Meta-analysis
• ISSN: 2224-5820; 2224-5839
• DOI: 10.21037/apm-20-1100

In recent years, phosphodiesterase type 5 (PDE5) inhibitors have been proposed for relieving the ureteral stent-related symptoms. We conducted a meta-analysis to assess the efficacy and safety of PDE5 inhibitors in the treatment of ureteral stent-related symptoms. Randomized controlled trials (RCTs) that reported on the effectiveness of PDE5 inhibitors on ureteral stent-related symptoms were identified and collected from Medline, Embase, and Cochrane Library databases. Four RCTs involving 352 patients were included. Following treatment with PDE5 inhibitors for 1 week, significant improvement of urinary symptoms (P<0.00001) and sexual health (P=0.04) was observed in the PDE5 inhibitors group. After 3 weeks, we found that PDE5 inhibitors were effective in relieving urinary symptoms [mean difference (MD): -11.94, 95% confidence interval (CI): -22.58 to -1.3, P=0.03], body pain (MD: -5.38, 95% CI: -9.35 to -1.41, P=0.008), and improving sexual health (MD: -4.13, 95% CI: -5.07 to -3.19, P<0.00001), general health (MD: -3.92, 95% CI: -5.76 to -2.08, P<0.0001), and additional health (MD: -2.21, 95% CI: -4.03 to -0.40, P=0.02). With regards to work performance (MD: -2.25, 95% CI: -5.13 to -0.62, P=0.12), no significant differences were observed between the PDE5 inhibitors group and the placebo group. In terms of safety, there were no significant differences between these two groups in the incidence of gastrointestinal [odds ratio (OR): 1.25, 95% CI: 0.51 to 3.04, P=0.63], or respiratory (OR: 1.48, 95% CI: 0.50 to 4.44, P=0.48) complications. PDE5 inhibitors were effective in relieving symptoms of patients undergoing ureteral stent placement, and do not increase the risk of complications.