Efficacy and Safety of Alpha-Blockers for Kidney Stones in Adults

Abstract

Kidney stones are a common and growing problem in the United States. A recent survey found that 11% of men and 7% of women will experience at least one kidney stone in their lifetime. Recurrence is estimated to be ≤50% at 5 years. Risk factors include male gender, obesity, diabetes, gout, and income less than $75 000. Noncontrast computed tomography imaging is typically used to confirm diagnosis and estimate stone size. Pain is the most common symptom and occurs when the stone attempts to pass through the ureter. Kidney stones are often asymptomatic while growing and may take up to several months to grow to a detectable size. 1-3 Treatment of kidney stones depends on factors such as stone size and symptoms. Waiting for a stone to pass spontaneously is the recommended treatment for stones <5 mm with little to no pain. Management options for larger and painful stones include shockwave lithotripsy (SWL), ureteroscopy, surgical removal, and pharmacologic therapy. While the traditional role of pharmacologic therapy is for symptomatic relief or to prevent recurrence, some studies suggest using medications to promote the passage of stones and shorten the time it takes to pass the stone spontaneously. This is referred to as medical expulsive therapy (MET) and is where the use of alpha-blockers has been studied. MET can be used as monotherapy, post-lithotripsy, or with additional pharmacologic therapy. 2 A 2002 to 2009 survey found that MET use was infrequent before 2007, and from 2007 to 2009, it was prescribed in 14% of emergency department urolithiasis visits. 3 This article compiles and briefly reviews the studies, including metaanalyses, that examined the efficacy and safety of alphablockers as MET in the treatment of kidney stones.

Factors Affecting the Outcome of Medical Treatment in Cats with Obstructive Ureteral Stones Treated with Tamsulosin: 70 Cases (2018–2022)

“…Although the inclusion criterion for the present study was not limited to the presence of distal ureter stones on computed tomography scans as in human studies [ 24 , 25 ], the findings of this study suggest that medical treatment with tamsulosin may be a safe option for feline patients with small distal ureter stones. If the cases included are only with stones in the distal ureter, a higher treatment success rate is expected.…”

Does treatment with dutasteride or finasteride has impact on renal morphology? Experimental study

“…The use of alpha-1 blockers may also be a good option in these cases. However, there is evidence that this class of drugs promotes various adverse effects, including renal adverse ones 29,30 .…”

Investigating the Influence of Tutukon and Alfuzosin on Stone Expulsion After Retrograde Intrarenal Surgery

“…Alpha receptor blockage inhibits basal smooth muscle cell tonus and hyperperistaltic wave frequency (6). Various studies have shown that alpha-blockers accelerate stone excretion and facilitate stone passage by causing relaxation of the smooth muscles of the ureteral wall (7,8).…”