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

BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS PDE5 inhibitors were effective in relieving symptoms of patients undergoing ureteral stent placement, and do not increase the risk of complications.