Managing Ureteral Stent-Related Symptoms: A Meta-Analysis Comparing Tadalafil with Tamsulosin
Abstract
Introduction: Ureteral stent-related symptoms (SRSs), colloquially termed “stent syndrome”, represent a post-operative morbidity impacting up to 80% of patients following endourological procedures. Although alpha1-blockers are the traditional standard of care, their efficacy in controlling stent-induced body pain and associated sexual dysfunction is often limited. This systematic review and meta-analysis evaluates the comparative therapeutic efficacy and safety profile of tadalafil versus tamsulosin across isolated monotherapy and combination therapy regimens. Methods: PubMed/MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception through May 15, 2026 for randomized controlled trials in adults with indwelling ureteral stents. Eligible trials directly compared tadalafil monotherapy with tamsulosin monotherapy, or tadalafil plus tamsulosin with tamsulosin alone. Outcomes of interest were Ureteral Stent Symptom Questionnaire (USSQ) domains and adverse events. Higher USSQ symptom-domain scores indicate greater symptom burden. Trial identity, arm-level denominators, drug doses, assessment timing, and bibliographic attribution were rechecked against the primary reports. Quantitative pooling was undertaken only when trial-level means, dispersion measures, and analyzable denominators were sufficiently and comparably reported; otherwise, findings were synthesized narratively to avoid unverifiable imputation. Results: Five…
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