Adjuvant alpha adrenergic blockers: Are they equally efficient for renal and upper ureteral calculi disintegrated by shock wave lithotripsy?

Elkoushy, Mohamed A

doi:10.1016/j.afju.2012.04.006

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…Of these five studies, three studies reported the number of patients with those adverse reactions. Two (3.9%) patients in the study reported by Naja et al (17), 16 (32.0%) patients in the study reported by Zaytoun et al (16), and 5 (8.0%) patients in the study reported by Elkoushy (11). Tamsulosin was well tolerated by most patients.…”

Section: Adverse Reactionsmentioning

confidence: 75%

Adjunctive medical expulsive therapy with tamsulosin for repeated extracorporeal shock wave lithotripsy: a systematic review and meta-analysis

et al. 2021

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Purpose: To evaluate the effi cacy of adjunctive medical expulsive therapy (MET) with tamsulosin for the promotion of stone fragments clearance for repeated extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: This meta-analysis was conducted by systematic search for randomized controlled trial (RCT) studies in PubMed/Medline, Scopus, Cochrane Library, Web of Science databases in January 2020, which compared tamsulosin with either placebo or non-placebo control for repeated ESWL. The primary endpoint was stonefree rate (SFR), the second endpoints were stone clearance time and complications. The quality assessment of included studies was performed by using the Cochrane System and Jadad score. Results: 7 RCTs were included in this meta-analysis. Tamsulosin provided higher SFR (for stones larger than 1cm, OR: 5.56, p=0.0003), except for patients with stones less than 1cm. For patients with renal stones (OR: 2.97, p=0.0005) or upper ureteral stones (OR: 3.10, p=0.004), tamsulosin can also provide a higher SFR. In addition, tamsulosin provided a shorter stone clearance time (WMD:-9.40, p=0.03) and lower pain intensity (WMD=-17.01, p <0.0001) and incidences of steinstrasse (OR: 0.37, p=0.0002). Conclusion: Adjunctive MET with tamsulosin is effective in patients with specifi c stone size or location that received repeated ESWL. However, no well-designed RCT that used computed tomography for the detection and assessment of residual stone fragments was found. More studies with high quality and the comparison between tamsulosin and secondary ESWL are needed in the future.

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Section: Adverse Reactionsmentioning

confidence: 75%

Adjunctive medical expulsive therapy with tamsulosin for repeated extracorporeal shock wave lithotripsy: a systematic review and meta-analysis

et al. 2021

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“…Four studies compared the effect of an alpha-blocker on stone free rates with SWL treatment [42][43][44]62]. SFRs were better with concomitant alpha-blocker use in all four studies; two of which provided statistically significant p values [42,43].…”

Section: Swl With Medical Expulsion Therapy [44] Versus Swl Alonementioning

confidence: 99%

“…Mean analgesic use (diclofenac) was also reduced in patients receiving nifedipine (p = 0.02). While one study showed number of SWL sessions needed was not significantly changed by alpha-blocker administration [43], another study showed that patients receiving tamsulosin required significantly less number of SWL sessions (p = 0.02) [42].…”

Section: Swl With Medical Expulsion Therapy [44] Versus Swl Alonementioning

confidence: 99%

“…SFRs were better with concomitant alpha-blocker use in all four studies; two of which provided statistically significant p values [42,43]. One study [45] looked at the effect of a calcium-channel blocker on SFRs with SWL treatment where SFRs were improved with nifedipine administration (75% compared with 44%, but no p value provided).…”

Section: Swl With Medical Expulsion Therapy [44] Versus Swl Alonementioning

confidence: 99%

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What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

et al. 2017

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“…Several randomized controlled trials (RCTs) studying the SFRs in different types of pharmacological therapy after ESWL have been reported 8 – 33 . However, most of these studies were designed to compare the clearance rates between one medication and control 8 – 10 , 12 , 13 , 15 – 20 , 22 – 32 . Moreover, in most studies, an arbitrary endpoint time was set to assess the stone clearance rate while ignoring possible variations of therapeutic effect before and after that endpoint time 8 – 14 , 18 , 19 , 21 , 23 , 25 , 26 , 28 , 29 , 31 – 33 .…”

Section: Introductionmentioning

confidence: 99%

A network meta-analysis on the beneficial effect of medical expulsive therapy after extracorporeal shock wave lithotripsy

Yang

Liao

Chen

et al. 2017

Sci Rep

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We applied a newly introduced method, network meta-analysis, to re-evaluate the expulsion effect of drugs including tamsulosin, doxazosin, nifedipine, terazosin and rowatinex after extracorporeal shock wave lithotripsy (ESWL) as described in the literature. A systematic search was performed in Medline, Embase and Cochrane Library for articles published before March 2016. Twenty-six studies with 2775 patients were included. The primary outcome was the number of patients with successful stone expulsion. The data were subdivided into three groups according to duration of follow-up. A standard network model was established in each subgroup. In 15-day follow-up results, SUCRA outcome showed the ranking of effects was: doxazosin > tamsulosin > rowatinex > nifedipine > terazosin (88.6, 77.4, 58.6, 32.2 and 30.4, respectively). In 45-day follow-up results, SUCRA ranking was: tamsulosin > nifedipine > rowatinex (69.4, 67.2 and 62.6, respectively). In 90-day follow-up results, SUCRA ranking was: doxazosin > rowatinex > tamsulosin (84.1, 68.1 and 49.1, respectively). In conclusion, doxazosin and tamsulosin have potential to be the first choice for pharmacological therapy to promote the expulsion of urinary stone fragments after ESWL, with this doxazosin can improve the SFR in the long term, while tamsulosin may result more in accelerating the process of expulsion.

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Adjuvant alpha adrenergic blockers: Are they equally efficient for renal and upper ureteral calculi disintegrated by shock wave lithotripsy?

Cited by 7 publications

References 17 publications

Adjunctive medical expulsive therapy with tamsulosin for repeated extracorporeal shock wave lithotripsy: a systematic review and meta-analysis

Adjunctive medical expulsive therapy with tamsulosin for repeated extracorporeal shock wave lithotripsy: a systematic review and meta-analysis

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

A network meta-analysis on the beneficial effect of medical expulsive therapy after extracorporeal shock wave lithotripsy

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