Tamsulosin for Ureteral Stones: A Systematic Review and Meta-Analysis of a Randomized Controlled Trial

Lu, Ze-Ping; Dong, Zhilong; Ding, Hui; Wang, Hanzhang; Ma, Ben; Wang, Zhiping

doi:10.1159/000338909

Cited by 42 publications

(32 citation statements)

References 68 publications

(61 reference statements)

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“…In the first meta-analysis, Lu et al identified 29 clinical trials, working with 2.763 patients (1.051 tamsulosin 0.4 mg/day, 145 tamsulosin 0.2 mg/day and 1.567 control) with upper and lower part of ureteral stones. 20 The authors reported a 19% improvement in stone clearance with tamsulosin. They concluded that tamsulosin has become a safe and effective MET choice for ureteral stones.…”

Section: Discussionmentioning

confidence: 97%

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

et al. 2014

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We evaluated the efficacy of tamsulosin and nifedipine in medical expulsive therapy (MET) in patients with distal ureteral stone. In addition, we tried to determine the predictive value of Hounsfield Unit (HU) of the stone in the success of MET. A total of 75 patients with a distal ureteral stone of 5-10 mm diameter were randomly divided into three groups. Group 1 (n ¼ 25) received tamsulosin 0.4 mg/d; group 2 (n ¼ 25) received nifedipine 10 mg/day p.o and group 3 (n ¼ 25) received diclofenac sodium 50 mg p.o. when required. At the beginning of each treatment, the HU of the stone was also measured using a non-contrast computerized tomography in all the patients. The results were evaluated at week four. The mean age of the patients was 36.8 (range, 16-68) years. Stone expulsion was observed in 19 (76%) patients in group 1, 16 (64%) patients in group 2 and 9 (36%) patients in group 3 (p group1-3 ¼ 0.004, p group2-3 ¼ 0.048 and p group1-2 ¼ 0.355). The mean expulsion time was 9, 9.1 and 10.3 d, respectively (p group1-3 50.001, p group2-3 50.001 and p group1-2 ¼ 0.619). The mean diclofenac sodium dose per patient was 544, 602 and 1408 mg in groups 1, 2 and 3, respectively (p group1-3 50.001, p group2-3 50.001 and p group1-2 ¼ 0.977). The mean HU of the stone in patients with and without a successful MET was 363 and 389, respectively (p ¼ 0.462). Our results showed that MET with both nifedipine and tamsulosin provided a similar increase in the expulsion rate for distal ureteral stones. HU does not seem to be a predictive parameter for stone expulsion.

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Section: Discussionmentioning

confidence: 97%

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

et al. 2014

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“…This could explain the reason for the observation that during pregnancy, stones are twice as likely to be found in the ureter than in the renal pelvis or calyxes. Physiological hydronephrosis caused by the enlarging uterus is present in 90% of pregnancies by the 3rd trimester [8,9,10,11]. This can make it more difficult to diagnose intramural obstruction during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…The management of urolithiasis in pregnancy is mainly conservative in the first instance, with spontaneous stone passage in approximately 70–80% of patients [9]. Expectant management includes hydration and analgesia.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Ureteroscopy for Stone Disease in Pregnancy: Results from a Systematic Review of the Literature

et al. 2012

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Introduction: Our aim was to evaluate the clinical efficacy and safety of ureteroscopy as a primary treatment for pregnant women with symptomatic ureteric stones who have failed conservative management. Materials and Methods: A systematic review of the literature from January 1990 to June 2011 was performed, including all English language articles. Outcome measures were clinical efficacy, in terms of stone clearance and need for additional procedures, and safety in terms of complications. Results: A total of 239 abstracts were screened and 15 studies were identified reporting on 116 procedures. The surgical methods of stone management employed were stone extraction with basket only (n = 55, 47%), laser fragmentation (n = 27, 23%; holmium, n = 20, pulse dye, n = 7), impact lithotripsy (n = 21, 18%), ureteroscopic lithotripsy (n = 6, 5%) and a combination of methods (n = 6, 5%). A post-operative stent was inserted in 64 of 116 procedures (55%). Complete stone clearance was seen in 100 of the 116 procedures (86%). There were 2 major complications (1 ureteral perforation and 1 case of premature uterine contraction) and 7 minor complications (5 urinary tract infections and 2 cases of post-operative pain). Conclusion: This review suggests that stone clearance using ureteroscopy is a relatively safe option in pregnancy with a high success rate.

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“…α 1 -Adrenergic receptor antagonists dilate the ureteral lumen or decrease the tension of the ureteral lumen [25]. Comparison of tamsulosin with calcium-channel blockers shows that tamsulosin is more effective in controlling stone expulsion rate, has fewer adverse effects and results in less episodes of colic [26]. All findings in the literature indicate increased sympathetic system activity in the presence of a ureteral stone.…”

Section: Discussionmentioning

confidence: 99%

Does the Endoscopic Treatment of Lower Ureter Stones Affect Uroflowmetric Values? A Prospective Clinical Trial

et al. 2013

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Objectives: The aim of this study was to document if stones at the lower ureter alter the micturition capability of the patients and to investigate whether endoscopic removal of these stones restores normal urinary flow rates or not in the 3 months of follow-up. Methods: Forty patients with lower ureteral stone (group 1) and 20 control subjects with proximal ureteral stone (group 2) were enrolled into the study. All patients underwent uroflowmetry testing before and 3 months after the treatment for endoscopic stone removal. The mean average and peak flow rates with a sufficient voided volume (≥150 ml) were evaluated before and after surgery and compared between the groups. Results: Mean values of the peak flow rates before and after surgery were 20.3 and 27.5 ml/s in group 1 and 22.5 and 23.6 ml/s in group 2, and the mean average flow rate values before and after surgery were 10.5 and 13.6 ml/s in group 1 and 11.4 and 12.1 ml/s in group 2. Statistically significant differences were determined between before and after ureteroscopy values were determined in terms of average (p < 0.05) and peak flow rates (p < 0.01) in group I; however, there no significant difference was seen in the control group. Conclusion: We document for the first time in the literature that patients with lower ureteric stones have a reduction in their urinary stream which resolves with endoscopic removal of the stones.

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Tamsulosin for Ureteral Stones: A Systematic Review and Meta-Analysis of a Randomized Controlled Trial

Cited by 42 publications

References 68 publications

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

Outcomes of Ureteroscopy for Stone Disease in Pregnancy: Results from a Systematic Review of the Literature

Does the Endoscopic Treatment of Lower Ureter Stones Affect Uroflowmetric Values? A Prospective Clinical Trial

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