PDE-5 Inhibitor And Alpha Blocker In The Treatment Of Distal Ureteral Calculi:A Systematic Review

Objective:In this study,a meta-analysis of PDE-5 inhibitors(Phosphodiesterase inhibitor 5)and alpha receptor blockers for the treatment of distal ureteral calculi was conducted to compare the efficacy of PDE-5 inhibitors with alpha receptor blockers in the treatment of distal ureteral calculi.Methods:Pubmed,Cochrane library,EMbase,CNKI,VIP,CBM and WanFang Date database were retrieved by computer,and a randomized controlled trial of PDE-5inhibitor and alpha receptor blockers for the treatment of lower ureteral calculi was systematically collected.The quality of the study was evaluated by 2 evaluators,and the data were extracted,and the REVMan5.3 software was used for Meta analysis.Results:After screening,11 papers were included in the study,with a total of 1002 patients.The meta-analysis results show that:(1)In the PDE-5 inhibitor group,the rate of stone removal was higher than that in the placebo group,[RD 0.26,95%CI(0.15,0.37)],and shorten the time of stone expulsion was [MD-4.39,95%CI(-6.69,-2.09)],P<0.05.(2)The rate of stone drainage was higher in the tamsulosin group than in the placebo group([RD 0.30,95%CI(0.23,0.38)),P<0.00001.(3)In the PDE-5 inhibitor group,the rate of stone removal was higher than that in the tamsulosin group [RD0.11,95%CI(0.04,0.18),P<0.05.Tadalafil and tamsulosin expulsion stone time comparison,[MD-1.33,95%CI(-2.44,-0.23),P=0.12.Conclusion:The available evidence supports,compared with placebo,PDE-5 inhibitors and tamsulosin can promote the stone expulsion rate for distal ureteral calculi,can significantly shorten the time of removing ureteral calculis;in stone clearance rate and stone expulsion time aspect,tadalafil is better than tamsulosin.