A Cochrane review [Abstract] 1 included 7 studies with a total of 494 subjects. Drug treatments assessed in studies in the review included cholinergic agents, alpha-blockers, sedatives and prostaglandin on their own or in combinations. No statistically significant associations were reported between successful treatment or any other outcome and cholinergic agents, alpha-blockers and sedatives as monotherapies. A statistically significant association between intravesically administered prostaglandin and successful voiding was detected (RR 3.07, 95% CI 1.22 to 7.72; 3 studies, n=84). There was variation in the time allowed for voiding. Also, the significance of this finding resulted from the addition of data from the trial of prostaglandin F2α to data from 2 trials of prostaglandin E2. Meta-analysis of prostaglandin E2 data alone found no significant association between treatment and successful voiding. A statistically significant association was detected between cholinergic agents combined with sedative and an improved likelihood of spontaneous voiding compared with placebo (RR 1.39, 95% CI 1.07 to 1.82, statistical heterogeneity I2 =80%; 2 studies, n=192).
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and blinding), by inconsistency (heterogeneity in interventions and outcomes), and by imprecise results (limited study size for each comparison).
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