The Effect of Alpha-Blockade in Emergency Department Patients with Ureterolithiasis

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

doi:10.1016/j.jemermed.2008.08.032

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…Three metaanalyses have confirmed a positive effect of alpha-blocker therapy on the stone expulsion rates (8)(9)(10)(11). Alphablockade has been proved to improve the likelihood of spontaneous stone passage, and to decrease both the time to stone passage and analgesic requirements (12). According to European Association of Urology Guidelines, alpha-blockers or nifedipine are recommended for MET (grade of recommendation A) (13).…”

Section: Introductionmentioning

confidence: 99%

Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

Imperatore

Fusco²,

Creta

et al. 2014

Arch Ital Urol Androl

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Section: Introductionmentioning

confidence: 99%

Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

Imperatore

Fusco²,

Creta

et al. 2014

Arch Ital Urol Androl

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“…(10)(11)(12)(13) Alpha blockade using tamsulosin has been proved to improve the likelihood of spontaneous stone passage, and to decrease both the time to stone passage and analgesic requirements. (14) The selective alpha1A adrenergic receptor antagonist, silodosin, was more effective than other drugs used MET. (15,16) However there are few clinical studies that compared silodosin to tamsulosin as MET for lower ureteric stones.…”

Section: Introductionmentioning

confidence: 99%

Randomized Trial of the Safety and Efficacy of Tamsulosin and Silodosin in Medical Expulsive Therapy for Distal Third Ureteric Calculi

B¹,

Manjunath²,

Harsharvardhan³

2014

jemds

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Urolithiasis is a common condition that affects approximately 5% to 10% of the population and the incidence of Urolithiasis is rising. Ureteric stones account for 20% of urinary tract stones and about 70% of them are found in the lower third of the ureter at presentation. Recent literatures show the efficacy of various drugs and minimally invasive procedures for the management of lower third ureteral stones. We performed a randomized, prospective study to assess and compare the efficacy of tamsulosin and silodosin as medical expulsive therapy for lower third ureteral stones.

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Does tamsulosin change the management of proximally located ureteral stones?

et al. 2010

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The objective of this study is to assess the efficacy of an alpha-1 adrenergic receptor blocking agent on the spontaneous passage of proximal ureteral calculi < or =10 mm. 92 patients having single radio-opaque proximal ureteral stone < or =10 mm were randomized into two groups. Group 1 patients (n = 50) were followed with classical conservative approach and patients in Group 2 (n = 42) additionally received tamsulosin, 0.4 mg/day during 4 weeks follow-up. The stone passage rates, stone expulsion time, VAS score, change in colic episodes, and hospital re-admission rates for colicky pain were compared. The patients were furthermore stratified according to stone diameters <5 and 5-10 mm. The data of these subgroups were also compared. Stone expulsion rates showed statistically significant difference between tamsulosin receivers and non-receivers (35.7 vs 30%, p = 0.04). Time to stone expulsion period was also shortened in those receiving tamsulosin (8.4 +/- 3.3 vs 11.6 +/- 4.1 days, p = 0.015). Likewise, the mean VAS score and renal colic episodes during follow-up period were significantly diminished in Group 2 patients (4.5 +/- 2.3 vs 8.8 +/- 2.9, p < 0.01 and 66.6 vs 36%, p = 0.001, respectively). Among the stones <5 mm, tamsulosin receiving patients had higher spontaneous passage rate (71.4 vs 50%, p < 0.001). The prominent effect of tamsulosin on the 5-10 mm stones was the relocation of the stones to a more distal part of ureter (39.3 vs 18.7%, p = 0.001). Administration of tamsulosin in the medical management of proximal ureteral calculi can facilitate the spontaneous passage rate in the stone <5 mm and the relocation of the stones between 5 and 10 mm to more distal part of the ureter.

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The Effect of Alpha-Blockade in Emergency Department Patients with Ureterolithiasis

Cited by 6 publications

References 16 publications

Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

Randomized Trial of the Safety and Efficacy of Tamsulosin and Silodosin in Medical Expulsive Therapy for Distal Third Ureteric Calculi

Does tamsulosin change the management of proximally located ureteral stones?

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