Emergency physicians report infrequent use of α-blockade for the treatment of ureteral stones

Chan, Cindy W.; Tekwani, Karis L.; Watts, Hannah; Kulstad, Erik

doi:10.1016/j.ajem.2008.06.007

Cited by 5 publications

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[8][9][10][11] In a study published in 2009, emergency physicians reported prescribing tamsulosin for less than 25% of their patients with ureterolithiasis, and a comparable proportion said they had never heard of this therapy. 12 A more recent survey observed that only 55% of emergency physicians reported usually or always using medical expulsive therapy for patients with distal ureterolithiasis , 10 mm. When a medical expulsive therapy was used, tamsulosin was prescribed only about 50% of the time.…”

Section: Ré Sumémentioning

confidence: 99%

Tamsulosin for treatment of unilateral distal ureterolithiasis: a systematic review and metaanalysis

Malo

Audette-Côté

Émond

et al. 2014

CJEM

View full text Add to dashboard Cite

Objectives: The lifetime prevalence of ureterolithiasis is approximately 13% for men and 7% for women in the United States. Tamsulosin, an a-antagonist, has been used as therapy to facilitate the expulsion of lithiasis. Whether it is a good treatment for distal lithiasis remains controversial. We conducted a systematic review and meta-analysis to evaluate the effect of tamsulosin on the passage of distal ureterolithiasis. Methods: A systematic search was conducted using MEDLINE, EMBASE, and Cochrane Central. Trial eligibility was evaluated by two investigators. All randomized controlled trials (RCTs) comparing tamsulosin to standard therapy or placebo for the treatment of a single distal ureterolithiasis # 10 mm in adult patients with renal colic confirmed by radiographic imaging were included. Data extraction was conducted in duplicate. Primary outcome was the expulsion rate, and secondary outcomes were the mean time for ureterolithiasis expulsion, analgesic requirements, and side effects. Mantel-Haenszel random effect models were used, and heterogeneity was assessed using I 2 statistics. Data were presented with relative risks (RRs). Results: The search strategy identified 685 articles, of which 22 studies were included. Combined results suggested a benefit for the expulsion of ureterolithiasis (# 10 mm) when tamsulosin was used compared to a standard treatment (RR 1.50 [95% CI 1.31-1.71], I 2 5 70%). A decrease in the average time of expulsion of the ureterolithiasis of 3.33 days in favour of tamsulosin was observed (95% CI 24.23, 22.44], I 2 5 67%). Conclusion: Tamsulosin increases the rate of spontaneous passage of distal ureterolithiasis (# 10 mm). RÉ SUMÉObjectif: La pré valence de la lithiase uré té rale au cours de la vie est d'environ 13% chez les hommes et 7% chez les femmes aux É tats-Unis. La tamsulosine, un alpha-bloquant, est utilisé e comme traitement pour faciliter l'expulsion des calculs; toutefois, le recours à ce traitement dans la lithiase distale fait l'objet de controverse. Nous avons donc mené un examen mé thodique et une mé ta-analyse afin d'é valuer l'effet de la tamsulosine sur le passage des lithiases uré té rales distales. Mé thode: Une recherche mé thodique a é té effectué e dans les bases de donné es MEDLINE, EMBASE, et Cochrane Central, et l'acceptabilité des essais a é té soumise à l'examen de deux chercheurs. Ont é té retenus tous les essais comparatifs, à ré partition alé atoire, visant à mettre en parallè le la tamsulosine avec les procé dé s thé rapeutiques habituels ou avec un placé bo dans le traitement d'une seule lithiase uré té rale distale,# 10 mm, confirmé e à la radiographie, chez des adultes souffrant de colique né phré tique. L'extraction des donné es a é té ré alisé e en double. Le principal critè re d'é valuation é tait le taux d'expulsion, et les critè res d'é valuation secondaires portaient sur le temps moyen é coulé avant l'expulsion des lithiases uré té rales, l'administration d'analgé siques, et les effets indé sirables. Nous avons eu recours aux modè...

show abstract

Section: Ré Sumémentioning

confidence: 99%

Tamsulosin for treatment of unilateral distal ureterolithiasis: a systematic review and metaanalysis

Malo

Audette-Côté

Émond

et al. 2014

CJEM

View full text Add to dashboard Cite

show abstract

Tamsulosin does not have greater efficacy than conventional treatment for distal ureteral stone expulsion in Mexican patients

et al. 2011

View full text Add to dashboard Cite

The objective of the study was to evaluate tamsulosin (TAM) efficacy in distal ureteral stone expulsion in Mexican patients. A double-blind clinical trial was carried out for a period of 4 weeks on 65 patients assigned to the following treatment groups: Group A, 32 patients receiving conventional treatment + TAM; and Group B, 33 patients receiving conventional treatment + placebo. Patients of both groups were checked every 14 days to evaluate treatment adherence and clinical progression through plain abdominal film and abdominal ultrasonogram. There was no significant difference in stone expulsion percentage between groups: Group A 69% (n = 22) versus Group B 70% (n = 23), P = 0.9. There was no significant difference in mean expulsion time comparison between groups: Group A 22 ± 6.7 days (11-30 days interval) versus Group B 23 ± 6.3 days (11-30 days interval), P = 0.3. Tamsulosin did not demonstrate greater efficacy in distal ureteral stone expulsion in Mexican patients.

show abstract

Tamsulosin does not increase 1-week passage rate of ureteral stones in ED patients

Berger

Ross

Hollander

et al. 2015

The American Journal of Emergency Medicine

View full text Add to dashboard Cite

Emergency physicians report infrequent use of α-blockade for the treatment of ureteral stones

Cited by 5 publications

References 11 publications

Tamsulosin for treatment of unilateral distal ureterolithiasis: a systematic review and metaanalysis

Tamsulosin for treatment of unilateral distal ureterolithiasis: a systematic review and metaanalysis

Tamsulosin does not have greater efficacy than conventional treatment for distal ureteral stone expulsion in Mexican patients

Tamsulosin does not increase 1-week passage rate of ureteral stones in ED patients

Contact Info

Product

Resources

About