Prospective Randomized Trial Comparing Efficacy of Alfuzosin and Tamsulosin in Management of Lower Ureteral Stones

Agrawal, M. K.; Gupta, Manoj; Gupta, Apurva; Agrawal, Avyact; Sarkari, Avijit; Lavania, Prashant

doi:10.1016/j.urology.2008.11.013

Cited by 84 publications

(94 citation statements)

References 17 publications

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“…(21)(22)(23) Results from the present study in terms of mean number of pain episodes and need for analgesics are within the published ranges for both the drugs.…”

Section: Discussionsupporting

confidence: 78%

“…(17) In patients presenting with DUS of 610 mm without the use of MET, the reported spontaneous stone clearance rates are between 35.2% and 61% with mean expulsion times ranging between 9.87 and 24.5 days. (18)(19)(20)(21) Several factors can affect spontaneous stone clearance of DUS including: stone size, site, number and also the presence or absence of ureteric smooth muscle spasm and/or submucosal oedema. Coll et al found a direct relationship between stone size and spontaneous clearance.…”

Section: Discussionmentioning

confidence: 99%

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A Prospective Study Comparing Tamsulosin and Silodosin in Medical Expulsive Therapy for Lower Ureteric Stones

Reddy¹,

Prathvi²,

Kulshreshtha³

et al. 2016

jemds

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The urinary stone disease is one of the most common afflictions of the modern society and it has been described since antiquity with the westernization of global culture. The efficacy of mini-invasive therapies, such as Extracorporeal Shock Wave Lithotripsy [ESWL] and ureteroscopy are not risk free, are problematic and are quite expensive. Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitate stone expulsion. MATERIALS AND METHODSThis prospective randomised study was conducted between September 2015 and May 2016 at Rajarajeshwari Medical College and Hospital, Bangalore. The cohort comprised 100 adult patients (54 men and 46 women) who presented with a symptomatic, unilateral, single, uncomplicated lower ureteric stone of ≤ 10 mm. Patients were randomized into two equal groups, 50 (50%) patients received a daily single dose of tamsulosin 0.4 mg for 28 days and 50 (50%) patients received a daily single dose of silodosin 8 mg for 28 days. Both groups were compared in terms of patient's demographics, socioeconomic status, stone size and side, type of MET, stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use and incidence of side effects. Subgroup analysis was performed according to stone size ≤ or > 5 mm. RESULTSNo significant differences among the two groups for patient's age, gender, stone side and stone size. Spontaneous stone expulsion rate within 28 days was observed in 44 (88%) patients in the tamsulosin group and in 45 (90%) patients in the silodosin group without statistically significant differences. There were no statistically significant differences observed in terms of mean expulsion time, mean number of pain episodes and need for analgesics. Retrograde ejaculation was significantly higher in the silodosin arm, while the incidence of side effects related to peripheral vasodilation were higher in the tamsulosin arm, but it was statistically insignificant. CONCLUSIONTamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associated with a lower incidence of side effects related to peripheral vasodilation, but a higher incidence of retrograde ejaculation when compared to tamsulosin. However, a multicentre study on a larger scale is needed to evaluate the current medicines. KEYWORDSTamsulosin, Silodosin, Stone Expulsion Rate, Medical Expulsion Therapy (MET). Financial or Other, Competing Interest: None. Submission 18-06-2016, Peer Review 13-07-2016, Acceptance 18-07-2016, Published 25-07-2016. Corresponding Author: Dr. Sreedhar Reddy, Professor and HOD, Department of Urology Raja Rajeshwari Medical College and Hospital, Bangalore. E-mail: urologyreddy@yahoo.com DOI: 10.14260/jemds/2016 Nevertheless these techniques are not risk free, are problematic and are quite expensive. (4) Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitat...

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“…(21)(22)(23) Results from the present study in terms of mean number of pain episodes and need for analgesics are within the published ranges for both the drugs.…”

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

A Prospective Study Comparing Tamsulosin and Silodosin in Medical Expulsive Therapy for Lower Ureteric Stones

Reddy¹,

Prathvi²,

Kulshreshtha³

et al. 2016

jemds

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“…Yapılan çalışmalarda benign prostat hiperplazi (BPH)'si semptomlarının tedavisinde kullanılan tüm alfablokerlerin (tamsulosin, doksazosin, terazosin, alfuzosin, naftodipil ve silodosin) benzer etkinlikte olduğu görülmüştür (22)(23)(24)(25). Ayrıca alfabloker ile birlikte steroid verilmesinin etkinliği artırdığına dair kanıtlar bulunmakla birlikte, kanıt düzeyi düşük olduğu için rutin olarak önerilmemektedir (21).…”

Section: D) Alfa-blokerler Ve Kalsiyum Kanal Blokerleriunclassified

Üriner Sistem Taş Hastalığı ve Ağrı Tedavisi: Yeni Ne Var?

Bayar¹,

Tanrıverdi²

2017

Endouroloji

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“…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.…”

Section: Pacientesunclassified