Tamsulosin Hydrochloride vs Placebo for Management of Distal Ureteral Stones

Vincendeau, S.

doi:10.1001/archinternmed.2010.447

Cited by 47 publications

(46 citation statements)

References 25 publications

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“…Sebastein V et al studied that out of total 129 patients, at inclusion, mean (SD) stone diameters were 3.2 (1.2) and 2.9 (1.0) mm in the placebo and tamsulosin groups. 17 In present study in group A only 12 (24%) patients experienced pain relapses whereas in group B 32 (64%) patients reported pain relapses. In group A 38 (76%) patients experienced no episode of relapse of pain whereas only 18 (36%) patients were pain free in group B.…”

Section: Discussioncontrasting

confidence: 47%

Role of tamsulosin in the management of lower ureteric stone at tertiary care hospital in Western Rajasthan, India

Chandawat

Kumar

et al. 2017

Int Surg J

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Background: Many minimally invasive interventional techniques as well as expectant treatments exist for the management of lower ureteric calculi.Methods: 100 patients [group A (50 patients) patients given capsule tamsulosin 0.4mg, 1 daily up to 4 weeks while group B (50 patients) patients given regularly practiced treatment without Tamsulosin] with distal ureteric stone included in the study. Study duration was 6 months and study performed at S.P. Medical College. Bikaner, Rajasthan, India.Results: Group A showed a statistically significant advantage in terms of the stone expulsion rate. 41 patients (82%) in group A and 30 patients (60%) in group B expelled stones. Overall patients in group A had mean expulsion time of 7.86 days, whereas in group B mean expulsion time was 18.64 days. In group A stone expulsion rate was higher as compared to group B. In group A only 12 (24%) patients experienced pain relapses whereas in group B 32 (64%) patients reported pain relapses. The diclofenac dosage required in group A was observed to be 1.62 tablets whereas in group B it was 2.6 tablets.Conclusions: It is concluded that tamsulosin should be considered for uncomplicated distal ureteral calculi before ureteroscopy or extracorporeal lithotripsy. Tamsulosin has been found to increase and hasten stone expulsion rates, decrease acute attacks by acting as a spasmolytic, reduces mean days to stone expulsion and decreases analgesic dose usage.

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Section: Discussioncontrasting

confidence: 47%

Role of tamsulosin in the management of lower ureteric stone at tertiary care hospital in Western Rajasthan, India

Chandawat

Kumar

et al. 2017

Int Surg J

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“…Among the 8 placebo-controlled, double-blinded, randomized trials of tamsulosin in patients with ureteral stones, only 1 included ureteral stones of all locations, 8 whereas the remaining studies included distal ureteral stones identified by CT or kidney, ureter, and bladder radiographs. Four studies were conducted in an emergency department (ED) setting, 8,9,19,23 and 4 were conducted in urology clinics in a number of different countries, 17,18,21,24 including Australia, Egypt, France, India, Qatar, Switzerland, the United Kingdom, and the United States.…”

Section: Resultsmentioning

confidence: 99%

“…Six trials provided tamsulosin for 28 days, 1 provided the drug for 21 days, 21 and the remaining study provided tamsulosin for 42 days. 23 The control group in each study received a placebo pill.…”

Section: Resultsmentioning

confidence: 99%

“…The effect of stone size is consistent across the 4 studies that included both small and large subgroups because tamsulosin is associated with a benefit in the large stone subgroups and not in the small stone subgroup. 8,9,21,27 Chance alone is unlikely to explain the difference in the effect of tamsulosin because the 95% CIs of the effect on small versus large subgroups do not overlap.…”

Section: Discussionmentioning

confidence: 99%

“…25,26 There is substantial heterogeneity in the reported incidence of dizziness, with some studies reporting 20% of both cohorts experiencing dizziness and several other studies reporting no harm-related events. 17,18,24,27 Also, no included studies calculated the power to detect differences in adverse effects. These limitations should be taken into account when the reliability of the dizziness and postural hypotension findings is considered, even when combined in a meta-analysis.…”

Section: Limitationsmentioning

confidence: 99%

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Effect of Tamsulosin on Stone Passage for Ureteral Stones: A Systematic Review and Meta-analysis

Wang

Smith‐Bindman

Whitaker

et al. 2017

Annals of Emergency Medicine

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Twitter: @ralphcwang.Study objective: Tamsulosin is recommended for patients receiving a diagnosis of a ureteral stone less than 10 mm who do not require immediate urologic intervention. Because of conflicting results from recent meta-analyses and large randomized controlled trials, the efficacy of tamsulosin is unclear. We perform a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone.Methods: MEDLINE, EMBASE, and CENTRAL databases were searched without language restriction through November 2015 for studies assessing the efficacy of tamsulosin and using a double-blind, randomized, controlled trial design. Meta-analysis was conducted with a random-effects model and subgroup analyses were conducted to determine sources of heterogeneity.Results: Eight randomized controlled trials (N¼1,384) contained sufficient information for inclusion. The pooled risk of stone passage in the tamsulosin arm was 85% versus 66% in the placebo arm, but substantial heterogeneity existed across trials (I 2 ¼80.2%; P<.001). After stratifying of studies by stone size, the meta-analysis of the large stone subgroup (5 to 10 mm; N¼514) indicated a benefit of tamsulosin (risk difference¼22%; 95% confidence interval 12% to 33%; number needed to treat¼5). The meta-analysis of the small stone subgroup (<4 to 5 mm; N¼533) indicated no benefit (risk difference¼-0.3%; 95% confidence interval -4% to 3%). Neither meta-analysis for the occurrence of dizziness or hypotension showed a significant effect. Conclusion:Tamsulosin significantly improves stone passage in patients with larger stones, whereas the effect of tamsulosin is diminished in those with smaller stones, who are likely to pass their stone regardless of treatment.

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Good Research Leads to Better Care

Veysman¹

2011

Arch Intern Med

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Tamsulosin Hydrochloride vs Placebo for Management of Distal Ureteral Stones

Abstract: clinicaltrials.gov Identifier: NCT00151567.

Cited by 47 publications

References 25 publications

Role of tamsulosin in the management of lower ureteric stone at tertiary care hospital in Western Rajasthan, India

Role of tamsulosin in the management of lower ureteric stone at tertiary care hospital in Western Rajasthan, India

Effect of Tamsulosin on Stone Passage for Ureteral Stones: A Systematic Review and Meta-analysis

Good Research Leads to Better Care

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