Alfuzosin Stone Expulsion Therapy for Distal Ureteral Calculi: A Double-Blind, Placebo Controlled Study

Abstract

Alfuzosin improves the patient discomfort associated with stone passage and decreases the time to distal ureteral stone passage but it does not increase the rate of spontaneous stone passage.

Comparing the Efficacy of Tamsulosin and Silodosin in the Medical Expulsion Therapy for Ureteral Calculi

“…The treatment effect on the expulsion rate was partially lost, as the sizes of the stones decreased, because of the high spontaneous expulsion rate of the small stones [3]. Although most of the studies used tamsulosin, which is a selective a1A/a1D adrenergic receptor antagonist, the efficacies of the other alpha blockers such as doxazosin, terazosin, alfuzosin and naftopidil were also indicated [16][17][18]. Silodosin was approved for BPH by the US Food and Drug Administration in October 2008.…”

Efficacy of low dose tamsulosin in medical expulsive therapy for ureteral stones in Japanese male patients: A randomized controlled study

“…17 Many studies have been published on the clinical efficacy of a blockers to promote the passage of distal ureteral stones since the first report in 2002. 5,6,[8][9][10][11][12] Two meta-analyses provided a high level of evidence for clinical benefit of a blockers in patients with distal ureteral calculi, in which patients given a blockers had a 52% and 44% greater likelihood of stone passage than those not given such treatment. 3,7 Although most studies used tamsulosin, which is a selective a1A/a1D adrenergic receptor antagonist, efficacy of other a blockers such as doxazosin, terazosin, alfuzosin and naftopidil was also indicated.…”

“…3,7 Although most studies used tamsulosin, which is a selective a1A/a1D adrenergic receptor antagonist, efficacy of other a blockers such as doxazosin, terazosin, alfuzosin and naftopidil was also indicated. 5,11,12,21 The advantage of medical expulsive therapy is important because the risks related to surgical intervention are not trivial. 22,23 Studies have reported that overall complication rates after ureteroscopy of 10-20%, with major complications such as ureteral perforation, avulsion and stricture, occurring 3-5% of procedures.…”

“…3,[5][6][7][8][9][10][11][12] Tamsulosin (0.4 mg/day) has been used in most of these studies, probably because of its tolerability and the lack of need for dose titration. In contrast, only low-dose tamsulosin (0.2 mg/day) for benign prostatic hyperplasia is covered by the Japanese health insurance system and there are few published clinical studies dealing with low-dose tamsulosin for medical expulsive therapy.…”

Uso de alfuzosina para la expulsión de cálculos del tercio distal del uréter

“…Hasta la fecha, existen dos trabajos publicados que evalúan la eficacia de alfuzosina; el primero de Nardi Pedro et al 32 , quienes reportaron una expulsión de 73,5% sin significación estadística y un porcentaje de días de expulsión de 5,19 ± 4,82 días, pero con cálculos, en promedio, de 4,8 mm. El segundo trabajo es de Madhusadan et al 33 , que compararon la eficacia de tamsulosina frente a alfuzosina y encontraron una eficacia similiar en ambos grupos.…”