Uso de alfuzosina para la expulsión de cálculos del tercio distal del uréter

Morúa, Alejandro García; García, José Antonio Guevara; Montelongo, Rafael Martínez; Guerra, Lauro Salvador Gómez

doi:10.1016/s0210-4806(09)72901-8

Cited by 11 publications

(4 citation statements)

References 31 publications

(18 reference statements)

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“…There were no significant difference in terms of mean stone size between the Alfuzosin-treated patients and the control study patients (5.94 vs. 5.94mm, respectively) as well as between the Alfuzosin-treated and Tamsulosin-treated groups (5.98 vs. 5.61mm, respectively). The methodological quality of the included studies was quite high for six of the RTCs (Jadad scale: 4–5 of 5 points)[ 11 , 12 , 13 , 15 , 16 , 17 ] and medium quality for three (Jadad scale: 2–3 of 5 points)[ 14 , 18 , 19 ]. The quality of evidence was considered to be moderate according to the GRADE system.…”

Section: Resultsmentioning

confidence: 99%

“…The quality of evidence was considered to be moderate according to the GRADE system. Two studies[ 11 , 18 ] reported the stones located in either the upper or lower ureter; the other seven studies[ 12 , 13 , 14 , 15 , 16 , 17 , 19 ] restricted to stones in the distal ureter. All except one trial[ 15 ] reported the additional medication administered for pain relief.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and Safety of Alfuzosin as Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

et al. 2015

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BackgroundAlfuzosin has been widely used to treat benign prostatic hyperplasia and prostatitis, and is claimed to be a selective agent for the lower urinary tract with low incidence of adverse side-effects and hypotensive changes. Recently, several randomized controlled trials have reported using Alfuzosin as an expulsive therapy of ureteral stones. Tamsulosin, another alpha blocker, has also been used as an agent for the expulsive therapy for ureteral stones. It is unclear whether alfuzosin has similar efficacy as Tamsulosin in the management of ureteral stones.ObjectiveTo perform a systematic review and analysis of literatures comparing Alfuzosin with Tamsulosin or standard conservative therapy for the treatment of ureteral stones less than 10 mm in diameter.MethodsA systematic literature review was performed in December 2014 using Pubmed, Embase, and the Cochrane library databases to identify relevant studies. All randomized and controlled trials were included. A subgroup analysis was performed comparing Alfuzosin with control therapy on the management of distal ureteral stones.ResultsAlfuzosin provided a significantly higher stone-free rate than the control treatments (RR: 1.85; 95% confidence interval [CI], 1.35–2.55; p<0.001), and a shorter stone expulsion time (Weighted mean difference [WMD]: -4.20 d, 95%CI, -6.19 to -2.21; p<0.001), but it has a higher complication rate (RR: 2.02; 95% CI, 1.30–3.15; p<0.01). When Alfuzosin was compared to Tamsulosin, there was no significant difference in terms of stone-free rate (RR: 0.90; 95% CI, 0.79–1.02; p = 0.09) as well as the stone expulsion time (WMD: 0.52 d, 95%CI, -1.61 to 2.64; p = 0.63). The adverse effects of Alfuzosin were similar to those of Tamsulosin (RR: 0.88; 95% CI, 0.61–1.26; p = 0.47).ConclusionsAlfuzosin is a safe and effective agent for the expulsive therapy of ureteral stones smaller than 10 mm in size. It is more effective than therapeutic regiment without alpha blocker. It is equivalent to Tamsulosin in its effectiveness and safety profile. Adverse effects should always be kept in mind when use this class of drugs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Alfuzosin as Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

et al. 2015

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“…García Morú a et al 7 realizaron un ensayo clínico con 30 pacientes con litiasis en el tercio distal del uré ter, que fueron aleatorizados a recibir bromuro de hioscina o alfuzosina. El grupo de alfuzosina presentó un tiempo de expulsió n má s corto que el grupo control, así como tambié n menor duració n del dolor y mayor tasa de expulsió n del cá lculo (88 frente a 40%).…”

Section: Discusió Nunclassified

Eficacia y seguridad de tamsulosina para el tratamiento conservador del cólico nefrítico: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados

et al. 2015

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“…On the other hand, waiting for stone removal can cause unwanted side effects such as kidney failure and urosepsis. 9,10 Therefore, it is necessary to select the right patient for proper management of ureteric stones. A biomarker that can predict which group of patients with ureteral stones will pass their stone spontaneously and which group is likely to require intervention, to guide the management of patients who are clinically stable at presentation, it is beneficial.…”

Section: Introductionmentioning

confidence: 99%

Investigating the predictive effect of neutrophil to lymphocyte ratio as an inflammatory marker in the spontaneous excretion of ureteral stones

Deldadeh-Moghaddam,

Cheraghi-Digaleh

2023

Int J Res Med Sci

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Background: The size and location of the stone have been suggested as the most important predictors of the possibility of spontaneous passage of the stone. The aim of this study was to investigate the predictive effect of neutrophil to lymphocyte ratio as an inflammatory marker in the spontaneous excretion of ureteral stones. Methods: This descriptive-analytical study was done on 95 patients with ureteral stone during 2020-21. Required data include sex, age, BMI, previous history of stone, previous history of spontaneous passage of stone, side, location and size of stones, spontaneous passage of stone, and neutrophil and lymphocyte ratio were extracted from file of patients. The presence of the stone and its characteristics were confirmed by ultrasound. Patients were followed up for 2 weeks to determine whether or not the stone passed spontaneously. Results: There was a significant relationship between spontaneous passage of ureteral stone with stone size, location, and neutrophil to lymphocyte ratio. The cut-off points of neutrophil to lymphocyte ratio for predicting spontaneous passage of ureteral stone was 2.52, so that patients with higher values were faced with a 4.2-fold increase in the risk of no spontaneous passage of stones (OR=4.202, 95% CI: 1.563-11.298, Sig.=0.004). Conclusions: The results of the study showed that the ratio of neutrophils to lymphocytes is a significant predictor of spontaneous passage of ureteral stones, so that if used in addition to the size and location of the stone, the accuracy of predicting patients who benefit from conservative management, increase significantly.

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Uso de alfuzosina para la expulsión de cálculos del tercio distal del uréter

Abstract: Use of alpha-adrenergic blockers for ureteral distal third stones has been shown to be effective for increasing the stone expulsion rate and even the number of stones passed, and for faster symptom relief.

Cited by 11 publications

References 31 publications

Efficacy and Safety of Alfuzosin as Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

Efficacy and Safety of Alfuzosin as Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

Eficacia y seguridad de tamsulosina para el tratamiento conservador del cólico nefrítico: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados

Investigating the predictive effect of neutrophil to lymphocyte ratio as an inflammatory marker in the spontaneous excretion of ureteral stones

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