Adjuvant Tamsulosin or Nifedipine After Extracorporeal Shock Wave Lithotripsy for Renal Stones: A Double Blind, Randomized, Placebo-controlled Trial

Vicentini, Fábio Carvalho; Mazzucchi, Eduardo; Brito, Artur Henrique; Neto, Elias Assad Chedid; Danilovic, Alexandre; Srougi, Miguel

doi:10.1016/j.urology.2011.04.062

Cited by 30 publications

(27 citation statements)

References 26 publications

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“…Their findings imply that α-blocker treatment could facilitate kidney stone passage and help decrease pain, as used in ureteral stones [11]. Several updated randomized clinical trials also confirmed the adjuvant effect of αblockers on improving stone free rates after surgical intervention of renal stones [23][24][25]. All studies consistently suggested the beneficial effect of α-blocker on stone recurrence; the possible mechanism may be due to the prevention of stone retention in the kidney and facilitation of stone passage via ureter.…”

Section: Discussionmentioning

confidence: 92%

391 Long-term prescription of α-blockers decrease the risk of recurrent urolithiasis needed for surgical intervention – a nationwide population-based study

Cc¹,

Hsieh²,

Cf³

et al. 2015

European Urology Supplements

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Purpose α1 receptors and subtypes have been confirmed to distribute in human pelvis and calyces recently. As used in ureteral stones, α-blocker treatment may facilitate kidney stone passage and long-term prescription of α-blocker may decrease the risk of recurrent urolithiasis. The aim of this study is to determine if use of α-blockers 180 days or more can decrease the risk of recurrent urolithiasis needed for surgical intervention. Materials and Methods A representative database of 1,000,000 patients from Taiwan's National Health Insurance was analyzed. Eligible patients were those who had received the first-time procedure for upper urinary stone removal, including extracorporeal shock-wave lithotripsy, ureterorenoscopic lithotripsy, or both, between 2000 and 2010. After completing a 180-day treatment for first event, patients were prospectively followed-up until a second set of stone procedures was performed (proxy of stone recurrence), loss to follow-up, or end of study. The effect of percentage of total number of days of α-blocker use on need for second set of stone procedures within a post treatment 180-day follow-up period was analyzed by quartile. A nested case-control study was also performed.

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Section: Discussionmentioning

confidence: 92%

391 Long-term prescription of α-blockers decrease the risk of recurrent urolithiasis needed for surgical intervention – a nationwide population-based study

Cc¹,

Hsieh²,

Cf³

et al. 2015

European Urology Supplements

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“…Some of the previous studies and systematic reviews demonstrated that the adjuvant administration of either nifedipine or tamsulosin augmented the stone expulsion rate compared with standard therapy or a placebo in patients with upper ureteral stones treated both with and without ESWL1819202122. Micali et al23 reported that among patients with upper-mid ureteral stones, nifedipine was more suitable and efficacious than tamsulosin for stones after ESWL.…”

Section: Discussionmentioning

confidence: 99%

A comparison of nifedipine and tamsulosin as medical expulsive therapy for the management of lower ureteral stones without ESWL

Cao

Yang

Liu

et al. 2014

Sci Rep

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Administration of nifedipine or tamsulosin has been suggested to augment stone expulsion rates. We aimed to compare the stone expulsion rates and adverse effects associated with the use of nifedipine or tamsulosin as medical expulsive therapy (MET) for the management of lower ureteral stones (LUS) without extracorporeal shock wave lithotripsy (ESWL) via a literature review and meta-analysis. Relevant randomized controlled trials (RCTs) were identified from the Medline, EMBASE, Cochrane CENTRAL, and Google Scholar databases. Finally, a total of 7 RCTs with 3897 patients were included. Our meta-analysis showed that tamsulosin could significantly increase the stone expulsion rate relative to nifedipine in patients with LUS (random-effects model; risk ratio [RR] = 0.81; 95% confidence interval [CI] = 0.75–0.88; P < 0.00001). The subgroup analysis indicated no statistically significant difference between the drugs with regard to minor or major adverse effects (fixed-effect model; RR = 1.19, 95% CI = 0.91–1.54, P = 0.20; and RR = 1.63, 95% CI = 0.22–11.82, P = 0.63, respectively). This meta-analysis demonstrated that tamsulosin was more effective than nifedipine in patients with LUS, as evidenced by the higher stone expulsion rate. Tamsulosin treatment should therefore be considered for patients with LUS.

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“…Other medication such as nifedipine have also proved effective as an adjunct to ESWL treatment, but with a higher rate of side effects such as dizziness and hypotension. 29 …”

Section: Eswl Adjuvant Factorsmentioning

confidence: 99%

Extracorporeal shock wave lithotripsy in the treatment of renal and ureteral stones

Torricelli

Danilovic

Vicentini

et al. 2015

Rev. Assoc. Med. Bras.

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Conflict of interest: noneThe use of certain technical principles and the selection of favorable cases can optimize the results of extracorporeal shock wave lithotripsy (ESWL). The aim of this study is to review how ESWL works, its indications and contraindications, predictive factors for success, and its complications. A search was conducted on the Pubmed ® database between January 1984 and October 2013 using "shock wave lithotripsy" and "stone" as key-words. Only articles with a high level of evidence, in English, and conducted in humans, such as clinical trials or review/ meta-analysis, were included. To optimize the search for the ESWL results, several technical factors including type of lithotripsy device, energy and frequency of pulses, coupling of the patient to the lithotriptor, location of the calculus, and type of anesthesia should be taken into consideration. Other factors related to the patient, stone size and density, skin to stone distance, anatomy of the excretory path, and kidney anomalies are also important. Antibiotic prophylaxis is not necessary, and routine double J stent placement before the procedure is not routinely recommended. Alpha-blockers, particularly tamsulosin, are useful for stones >10mm. Minor complications may occur following ESWL, which generally respond well to clinical interventions. The relationship between ESWL and hypertension/diabetes is not well established.

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Adjuvant Tamsulosin or Nifedipine After Extracorporeal Shock Wave Lithotripsy for Renal Stones: A Double Blind, Randomized, Placebo-controlled Trial

Cited by 30 publications

References 26 publications

391 Long-term prescription of α-blockers decrease the risk of recurrent urolithiasis needed for surgical intervention – a nationwide population-based study

391 Long-term prescription of α-blockers decrease the risk of recurrent urolithiasis needed for surgical intervention – a nationwide population-based study

A comparison of nifedipine and tamsulosin as medical expulsive therapy for the management of lower ureteral stones without ESWL

Extracorporeal shock wave lithotripsy in the treatment of renal and ureteral stones

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