The COMPARISON AND EFFICACY OF 3 DIFFERENT Α1-Adrenergic BLOCKERS FOR DISTAL URETERAL STONES

Yı́lmaz, Erdal; Batı̇slam, Ertan; Başar, M. Murad; Tuglu, Devrim; Ferhat, Mehmet; Başar, Halil

doi:10.1097/01.ju.0000158453.60029.0a

Cited by 235 publications

(175 citation statements)

References 13 publications

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“…The proportion of patients experiencing stone expulsion 249 within 21 days was even slightly, but not significantly lower in the tamsulosin arm than in the 250 placebo arm. This finding is in contrast to the results of previous clinical trials which have 251 reported significant improvements of the stone expulsion rate using tamsulosin [10][11][12]15]. 252…”

Section: % 144contrasting

confidence: 85%

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Is There a Role for Tamsulosin in the Treatment of Distal Ureteral Stones of 7mm or Less? Results of a Randomised, Double-Blind, Placebo-Controlled Trial

et al. 2009

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Section: % 144contrasting

confidence: 85%

“…A faster and less painful stone expulsion, irrespective of stone size, has constantly been 287 reported with MET [10,13,16]. In the present trial, median time to stone passage was three 288 days shorter for patients treated with tamsulosin than for patients treated with placebo.…”

Section: % 144supporting

confidence: 54%

Is There a Role for Tamsulosin in the Treatment of Distal Ureteral Stones of 7mm or Less? Results of a Randomised, Double-Blind, Placebo-Controlled Trial

et al. 2009

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“…It might therefore be expected that nonselective α1-adrenoceptor antagonists would be effective for the expulsion of ureteral stones. Actually, Yilmaz et al (2005) reported a few years ago that in humans, doxazosin and terazosin reduced the time to expulsion of distal ureteral stones with equal efficacy. In our study, the antagonist potency of doxazosin was almost the same as that of terazosin in each of the two species, in good agreement with the above clinical finding.…”

Section: Discussionmentioning

confidence: 99%

Effects of four different .ALPHA.1-adrenoceptor antagonists on .ALPHA.-adrenoceptor agonist-induced contractions in isolated mouse and hamster ureters

Kobayashi

Tomiyama

Maruyama

et al. 2009

J. Smooth Muscle Res.

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Purpose: To compare the efficacy of the selective α1A-adrenoceptor antagonist silodosin with those of doxazosin, terazosin, and alfuzosin against α-adrenoceptor agonist-induced contractions in mouse and hamster ureters. Methods: The four α1-adrenoceptor antagonists were evaluated against norepinephrine-induced phasic contractions in mouse isolated ureteral preparations and against phenylephrine-induced sustained contractions in hamster isolated ureteral preparations using a functional experimental technique. Results: In mouse ureters, silodosin (a selective α1A-adrenoceptor antagonist), doxazosin (a nonselective α1-adrenoceptor antagonist), terazosin (a nonselective α1-adrenoceptor antagonist), and alfuzosin (a nonselective α1-adrenoceptor antagonist) all shifted the norepinephrine concentration-response curve to the right. The rank order of potencies (pKB value) was silodosin (9.47 ± 0.16) > doxazosin (8.62 ± 0.15) > terazosin (8.39 ± 0.16) > alfuzosin (8.03 ± 0.12). In hamster ureters, all four antagonists shifted the phenylephrine concentration-response curve to the right, the rank order of potencies being silodosin (10.09 ± 0.13) > doxazosin (8.22 ± 0.16) > terazosin (7.75 ± 0.15) > alfuzosin (7.70 ± 0.10). In each case, silodosin was much more potent than the other three drugs. Conclusion: In this study, silodosin suppressed both mouse and hamster ureteral contractions more potently than doxazosin, terazosin, or alfuzosin. Hence, this α1A-adrenoceptor antagonist warrants further study as a potentially very useful medication for stone passage in urolithiasis patients.

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“…(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%

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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The COMPARISON AND EFFICACY OF 3 DIFFERENT Α1-Adrenergic BLOCKERS FOR DISTAL URETERAL STONES

Abstract: alpha1-Adrenergic blockers increase the frequency of spontaneous passage of the distal ureteral calculi. All 3 agents tested were equally efficacious.

Cited by 235 publications

References 13 publications

Is There a Role for Tamsulosin in the Treatment of Distal Ureteral Stones of 7mm or Less? Results of a Randomised, Double-Blind, Placebo-Controlled Trial

Is There a Role for Tamsulosin in the Treatment of Distal Ureteral Stones of 7mm or Less? Results of a Randomised, Double-Blind, Placebo-Controlled Trial

Effects of four different .ALPHA.1-adrenoceptor antagonists on .ALPHA.-adrenoceptor agonist-induced contractions in isolated mouse and hamster ureters

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

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