Urologia Internationalis
The Role of Phosphodiesterase Inhibitors in Acute Renal Colic: A Systematic Review and Meta-analysis
By Alhasan Altayf, Hashem Altabbaa, Mohamed R. Ezz and 3 others.
Abstract
Introduction
Acute renal colic is a common and intensely painful condition, primarily managed with non-steroidal anti-inflammatory drugs (NSAIDs). However, NSAIDs carry risks of gastrointestinal, renal, and cardiovascular adverse events. Phosphodiesterase (PDE) inhibitors, which promote ureteral smooth muscle relaxation, may offer an alternative for selected patients. This systematic review and meta-analysis assessed the efficacy and safety of PDE inhibitors compared with NSAIDs or placebo in acute renal colic.
Methods
PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched (inception to February 11, 2025) for RCTs comparing PDE inhibitors with NSAIDs or placebo. Study selection, data extraction, and risk of bias (Cochrane RoB 2) were independently performed. Evidence certainty was assessed via GRADE. Meta-analyses were conducted using mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs) under random-effects models; I² quantified heterogeneity.