MP06-10 WHAT COMBINATION OF URETERAL STENT BIOMATERIAL AND PHARMACOLOGY OPTIMIZES HEALTH-RELATED QUALITY OF LIFE (HRQOL)?: A MULTIPLE-TREATMENTS (NETWORK) META-ANALYSIS

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy I (MP06)1 Sep 2021MP06-10 WHAT COMBINATION OF URETERAL STENT BIOMATERIAL AND PHARMACOLOGY OPTIMIZES HEALTH-RELATED QUALITY OF LIFE (HRQOL)?: A MULTIPLE-TREATMENTS (NETWORK) META-ANALYSIS Scott Brockman, Zev Leopold, and Ephrem Olweny Scott BrockmanScott Brockman More articles by this author , Zev LeopoldZev Leopold More articles by this author , and Ephrem OlwenyEphrem Olweny More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001973.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A majority of stented patients experience negatively impacted HRQoL, modifiable by stent biomaterial, length and/or pharmacologic treatment. However, the optimal combination of stent biomaterial and pharmacologic treatment to improve ureteral stent symptoms has not been reported to date. METHODS: We systematically reviewed randomized controlled trials from January 2005 to October 2020, that reported HRQoL in stented patients using the validated USSQ. Patients received a combination of any of the following ureteral stent biomaterials: silicone (Sili), Percuflex (Pflx), polyurethane (PU), Surgitek, or Applied Medical Vertex (AMVtx), with any of the following pharmacological drugs: alfuzosin (alf), mirabegron (mirabeg), oxybutynin (oxy), pregabalin (Pgaba), solifenacin (soli), tamsulosin (tam), or tolterodine (tolter). The primary outcomes were USSQ urinary, pain and general health (GH) index scores (higher scores=worse HRQoL). Multivariable random effects network meta-analysis was used to compare the different biomaterial / pharmacologic combinations using direct and indirect evidence, ranking the strategies from best to worst using the surface under the cumulative ranking curve (SUCRA) method (higher SUCRA=better treatment). Referent strategy was Pflx without drug treatment. RESULTS: A total of 13 studies with 1606 patients met inclusion criteria. Mean age was 45.7 yr and 59.6% were male. Sili+tam and Pflx+soli+Pgaba were the treatment combinations that best optimized HRQoL in stented patients across all 3 USSQ domains (figure). By SUCRA values, the 3 highest ranking strategies across all HRQoL domains were Sili+tam, Pflx+soli+Pgaba and Pflx+mirabeg (table). CONCLUSIONS: In patients requiring ureteral stents, use of Percuflex stents along with solifenacin + pregabalin, or silicone stents along with tamsulosin, may best mitigate stent-associated discomfort. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e93-e93 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Scott Brockman More articles by this author Zev Leopold More articles by this author Ephrem Olweny More articles by this author Expand All Advertisement Loading ...