Effects of an α-blocker and Terpene Mixture for Pain Control and Spontaneous Expulsion of Ureter Stone

Bak, Chong Won; Yoon, Sang Jin; Chung, Hyun Sung

doi:10.4111/kju.2007.48.5.517

Cited by 14 publications

(5 citation statements)

References 14 publications

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“…There were no placebo-controlled studies. Two studies were for expectant treatment [ 8 , 10 ], three studies were for concomitant use with SWL [ 9 , 11 , 12 ], and one multicenter study was for both situations [ 14 ]. All studies used 0.2 mg tamsulosin per day.…”

Section: Resultsmentioning

confidence: 99%

Impact of Tamsulosin on Ureter Stone Expulsion in Korean Patients: A Meta-Analysis of Randomized Controlled Studies

Lee

Jeong

et al. 2012

Korean J Urol

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PurposeUsing meta-analysis, the study's aim was to evaluate the efficacy of tamsulosin, an alpha-blocker, in the treatment of ureteral stones with or without shockwave lithotripsy (SWL) in Korean patients.Materials and MethodsRelevant randomized controlled studies published through June 2011 were identified in a search of MEDLINE, KoreaMed, and the Korean Medical Database. No language restriction was applied. Only randomized controlled trials conducted with Korean patients were eligible for the analysis. The primary outcome assessed was the stone clearance rate. Two reviewers independently assessed the quality of the study and extracted the data. Meta-analysis was conducted by using R, version 2.13.0.ResultsA total of 6 articles were selected as being suitable for evaluation. Pooling of the trials demonstrated a 43% higher expulsion rate for tamsulosin treatment compared to a control group (risk ratio [RR], 1.43; 95% confidence interval [CI]: 1.24 to 1.65). Similar results were obtained in all subgroup analyses according to stone location (upper: RR, 1.31; 95% CI, 1.02 to 1.68, lower: RR, 1.50; 95% CI, 1.20 to 1.88) or concomitant SWL (yes: RR, 1.38; 95% CI, 1.14 to 1.68, no: RR, 1.48; 95% CI, 1.21 to 1.83).ConclusionsThis meta-analysis of randomized controlled studies provides a high level of evidence supporting the suggestion that treatment with tamsulosin augments the stone expulsion rate for ureter stones with or without SWL in a Korean population. However, a high-quality, large-scale, multicenter, randomized controlled trial is warranted to fully support this hypothesis.

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Section: Resultsmentioning

confidence: 99%

Impact of Tamsulosin on Ureter Stone Expulsion in Korean Patients: A Meta-Analysis of Randomized Controlled Studies

Lee

Jeong

et al. 2012

Korean J Urol

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“…25,26 As an example of clinical studies, Bak et al reported that the terpene combination reduced the frequency of pain in the urinary stone disease and provided a significant increase in the early spontaneous passage of stones. 27 In another study, Aldemir et al, comparing tamsulosin and terpene combination in the expulsion treatment of ˂10 mm distal ureteral stones, found that the rate of expulsion was 80.6% in the tamsulosin group and 43.3% in the terpene group (P = .002). 11 The authors did not detect a statistically significant difference in expulsion only in the comparison of the terpene group with the diclofenac group (37.9%) (P = .67).…”

Section: Discussionmentioning

confidence: 99%

“…It also shows anti‐inflammatory and analgesic effects through 1,8‐cineol and anethole and is therefore effective in preventing complications, such as spasm, inflammation, pain and infection related to renal or ureteral stones 25,26 . As an example of clinical studies, Bak et al reported that the terpene combination reduced the frequency of pain in the urinary stone disease and provided a significant increase in the early spontaneous passage of stones 27 . In another study, Aldemir et al, comparing tamsulosin and terpene combination in the expulsion treatment of ˂10 mm distal ureteral stones, found that the rate of expulsion was 80.6% in the tamsulosin group and 43.3% in the terpene group ( P = .002) 11 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of silodosin and a terpene combination in the medical expulsive therapy of distal ureteral stones

Şahin¹,

Şen²,

Ongün

et al. 2020

Int J Clin Pract

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Objective We aimed to compare the efficacy of silodosin and a terpene combination in the treatment of distal ureteral stones. Methodology The data of the patients admitted to the urology policlinic with renal colic, diagnosed with distal ureteral stones, and followed up with medical expulsive therapy between December 2017 and June 2018 were retrospectively reviewed. The patients were divided into two groups: Group 1 comprised 72 patients that received 8 mg/day silodosin and Group 2 consisted of 51 patients that were given three capsules of a terpene combination daily. The groups were compared in terms of the patients’ demographic characteristics, medical history, localisation of the present stone, renal collecting system status, daily fluid intake, number of emergency service visits, number of additional analgesic applications needed, number of pain attacks, number of days off work, stone expulsion rate and time to stone expulsion. Results Of the total 123 patients, 98 (79.7%) were stone‐free. The stone‐free rate was 75.0% in Group 1 and 86.3% in Group 2, with no statistical difference between the two groups. However, the number of visits to the emergency service because of pain, number of additional analgesic applications required, number of days off work, and time to stone expulsion were statistically significantly lower in Group 2 than in Group 1. Conclusions The treatment of distal ureteral stones with silodosin is as effective as the terpene combination. However, the terpene combination is more effective than silodosin in managing pain and accelerating stone expulsion.

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“…One of the major constituents that exist in Cnicus benedictus is “cnicin” that belongs to the terpenes family ( 13 14 ). There are numerous documents concerning the effects of terpene on treating pain ( 15 16 ). It has been also demonstrated that cnicin (as a terpene) has antibacterial and anti-inflammatory effects ( 17 18 ).…”

Section: Introductionmentioning

confidence: 99%

Antinociceptive activity of Cnicus benedictus L. leaf extract: a mechanistic evaluation

et al. 2020

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Background and purpose: Cnicus benedictus , a medicinal herb, traditionally had been used for the treatment of stomachache pain. In this study, the possible efficacy of Cnicus benedictus leaf methanolic extract (CBHE) and also cnicin, one of its major constituents, was measured on pain. Experimental approach: In this study, pain assessment tests include writhing, tail-flick (TF), and formalin- induced paw licking test (FIPLT) were used. To understand the possible mediated anti-nociceptive mechanism of CBHE, the opioid mechanism(s), and involvement of the L-arginine/ nitric oxide/cGMP/ATP-sensitive potassium channel pathway (LNCaP) were scrutinized. Findings/Results: In TF and writhing tests, CBHE (150 and 300 mg/kg, i.p) remarkably exhibited an anti-nociceptive effect compared to that of the control. Furthermore, CBHE (150 and 300 mg/kg, i.p) in comparison with the control showed a noteworthy anti-nociceptive effect ( P < 0.01) in the tonic phase of FIPLT. In the writhing test, administration of selective opioid antagonist (naltrindole, nor-binaltorphimine, and naloxonazine) attenuated the anti-nociceptive effect of CBHE (300 mg/kg) in comparison with control. Moreover, pre-treatment with Nω-nitro-L-arginine methyl ester hydrochloride, L-arginine hydrochloride, and glibenclamide significantly blocked the CBHE (300 mg/kg) anti-nociception ( P < 0.05) while administration of sodium nitroprusside remarkably potentiated ( P < 0.05) the antinociception induced by CBHE in the tonic phase of the FIPLT. Besides, cnicin (30 mg/kg) showed noteworthy anti-nociceptive effects in writhing, TF, and FIPLT paradigms. Conclusion and implications: Taken together, we elucidate that both CBHE and cnicin demonstrated antinociceptive effects in behavioral tests. The possible mechanisms of CBHE antinociception may involve in various neural signaling and modulatory pathways including LNCaP and opioidergic mechanisms.

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Effects of an α-blocker and Terpene Mixture for Pain Control and Spontaneous Expulsion of Ureter Stone

Cited by 14 publications

References 14 publications

Impact of Tamsulosin on Ureter Stone Expulsion in Korean Patients: A Meta-Analysis of Randomized Controlled Studies

Impact of Tamsulosin on Ureter Stone Expulsion in Korean Patients: A Meta-Analysis of Randomized Controlled Studies

Comparison of the efficacy of silodosin and a terpene combination in the medical expulsive therapy of distal ureteral stones

Antinociceptive activity of Cnicus benedictus L. leaf extract: a mechanistic evaluation

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