Efficacy of Pregabalin, Solifenacin, or Combination Therapy for Ureteral Stent Related Symptoms: A Systematic Review and Meta-Analysis

Objective: The Double-J (DJ) ureteral stent is essential in urology but can lead to Ureteral Stent-Related Symptoms (USRS), prompting research into various therapies to enhance patient comfort. The purpose of this study is to assess the efficacy of pregabalin, solifenacin, or combined therapy on ureteral stent-related symptoms. Materials and Methods: We conducted thorough searches in four databases, which included PubMed, Cochrane, EBSCO, and ProQuest. PRISMA Guideline 2020 was applied in this study. The risk of bias was assessed using Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0. Results: Ten studies consisting of 1477 participants were included in this study. Solifenacin monotherapy could significantly decrease total USSQ (mean difference (MD) -16.62; p=0.001), urinary symptoms (MD -9.16; p=0.002), and sexual matters (MD -0.81; p=0.002). Pregabalin monotherapy could significantly decrease pain (MD -7.29; p<0.00001). Compared to solifenacin monotherapy, combination therapy of pregabalin and solifenacin could significantly decrease total USSQ (MD -12.40; p <0.0001), urinary symptoms (MD -1.88; p=0.007), pain (MD -6.82; p<0.00001), sexual matters (MD -0.77; p <0.00001), and additional problems (MD -1.51; p=0.0007). Conclusion: Combination therapy of pregabalin and solifenacin had the best advantages in lowering USRS, especially urinary symptoms, pain, sexual matters, and some other additional problems.