Alpha-blockers after shock wave lithotripsy for renal or ureteral stones in adults

Abstract

Analysis 2.1. Comparison 2: Alpha-blocker and usual care versus usual care: stone location subgroup (renal and proximal ureter versus distal ureter), Outcome

Outcomes of alpha‐blockers as medical expulsive therapy following shockwave lithotripsy: a systematic review and meta‐analysis

“…The rationale underlying the use of alpha-blockers as MET is based on the presence of alpha-adrenoceptors in the ureter, which mediate contractility [30]. Contractility of the ureters in the presence of a stone may prevent passage [6]. Therefore, blocking alpha-adrenoceptors with alpha-blockers results in a reduction in contractility, thus dilating the ureter, theoretically increasing the likelihood of stone passage [6].…”

“…Unlike previous studies [6], we examined the likelihood of individual postoperative complications and categorized these according to the Clavien-Dindo system, as well as identifying the number of patients needing auxiliary procedures following MET after ESWL. We have shown that MET following SWL reduces the risk of the postoperative complications of pain and steinstrasse compared to control, and thus significantly decreases the need for auxilliary procedures.…”

“…Patients with kidney stone disease often have repeated episodes of ureteric colic, with recurrent presentations resulting in a high economic burden [5]. Stones may pass spontaneously or require medical or surgical intervention [6]. Medical expulsive therapy (MET) is a treatment using alpha-blockers, such as tamsulosin, or calcium channel blockers, such as nifepidine, to expedite stone passage.…”

“…However, stone clearance is not always achieved [4]. It has been suggested that treatment with MET after shockwave lithotripsy (SWL) may improve the chance of stone clearance and therefore achieve better outcomes than SWL alone [6].…”

α1-Adrenergic Receptors: Insights into Potential Therapeutic Opportunities for COVID-19, Heart Failure, and Alzheimer’s Disease

“…As in the vascular system, α 1 -AR antagonists affect the contraction of smooth muscle in several organ systems. α 1 -AR blockage results in the relaxation of smooth muscle in the prostate and ureter to increase urinary flow [ 98 , 99 , 100 ]. Since the 1980s and 1990s, α 1 -AR antagonists are frequently used medications in the management of benign prostatic hyperplasia (BPH), kidney stones, and in therapy-resistant arterial hypertension, two conditions frequently found in older adults.…”