A Systematic Review of Medical Therapy to Facilitate Passage of Ureteral Calculi

Singh, Aminder; Alter, H. J.

doi:10.1197/j.aem.2007.03.730

Cited by 20 publications

(27 citation statements)

References 73 publications

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“…It has been proven elsewhere that the likelihood and speed of spontaneous passage are increased with MET [1,3]. Furthermore, MET decreases hospital visits, costs, and the requirement of interventional treatment [4][5][6][7].…”

Section: Introductionmentioning

confidence: 97%

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

et al. 2020

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Background: Medical expulsive therapy (MET) is recommended for ureteral stones when there is no indication for interventional treatment. Spontaneous passage (SP) may not always be perceived in patients undergoing MET. We aimed to demonstrate the effects of inflammatory factors on spontaneous ureteral stone passage in patients undergoing MET. Methods: Our study was conducted between August and November, 2016, in healthy volunteers and patients with a single distal ureteral stone between 5 and 10 mm in diameter and no indications for interventional therapy. Blood and urine samples from all patients and healthy volunteers were tested. The patients were followed up every 2 weeks for 1 month unless emergency situations appeared. Patients with stone-free status at follow-up were concluded to have achieved complete stone passage [SP(+)], and failure [SP(−)] was concluded if the patient had not passed the stone by the end of the study. Blood samples of the patients and the control group were analyzed, recording WBC (white blood cell), CRP (c-reactive protein), SED (sedimentation), MPV (mean platelet volume), NLR (neutrophil-tolymphocyte ratio), and serum procalcitonin levels. Abnormalities in urine samples were recorded. All patients received diclofenac sodium 75 mg/day, tamsulosin 0.4 mg/day, and at least 3 l/day fluid intake. Patients were followed for a month with kidney, ureter, bladder (KUB) plain films, ultrasonography (USG), and unenhanced abdominal CT scans while undergoing MET. Comparative statistical analyses were performed between the SP(+) and SP(−) groups. Results: The procalcitonin levels of the SP(−) group were significantly higher (207 ± 145.1 pg/ml) than in the SP(+) group (132.7 ± 28.1 pg/ml) (p = 0.000). The leucocyturia rate of the SP(−) group was significantly higher than in the SP(+) group (p = 0.004). Based on the ROC curve analysis, 160 pg/ml (86.7% sensitivity, 70.8% specificity, p < 0.001; AUC: 0.788 95% CI (0.658-0.917) was identified as the optimal cut-off value for procalcitonin. In logistic regression analysis, a significant efficacy of procalcitonin and leucocyturia was observed in the univariate analysis on spontaneous passage. In the multivariate analysis, significant independent activity was observed with procalcitonin. (p < 0.05). Conclusion: Our findings suggest that high procalcitonin levels and the presence of leucocyturia have a strong negative effect on SP of ureteral stones between 5 and 10 mm in diameter. This relationship can be explained by stone impaction, possibly caused by increased mucosal inflammation.

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Section: Introductionmentioning

confidence: 97%

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

et al. 2020

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“…[1][2][3][4][5][6] Following recent findings that a-AR antagonists (a-blockers) decrease spontaneous or pharmacologically-induced ureteral contraction of the human ureter, many clinical studies have evaluated the efficacy of oral administration of a-AR antagonists for the treatment of ureteral stones. [7][8][9][10][11] However, although there is much evidence for the functional role of b-AR subtypes in the rat, rabbit, dog and porcine ureter, [12][13][14] little evidence is available for the expression, distribution and functional role of b-AR in the human ureter. 15 b-AR are now subclassified into b1-, b2and b3-AR subtypes.…”

Section: Introductionmentioning

confidence: 99%

Expression and functional role of β₃‐adrenoceptors in the human ureter

et al. 2013

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Abbreviations & AcronymsObjectives: To investigate the presence of b-adrenoceptor subtypes in the human ureter, and to examine whether b3-adrenoceptors modulate relaxation of the human ureter. Methods: Expression of messenger ribonucleic acid of b-adrenoceptors in the human ureter was determined by reverse transcription polymerase chain reaction, and distribution of b-adrenoceptors was examined by immunohistochemistry. In functional studies, the relaxant effects of isoproterenol, procaterol, TRK-380, salbutamol and BRL 37344 on KCl-induced contraction of the human ureter were evaluated, and the inhibitory effects of isoproterenol, procaterol and TRK-380 on electrical field stimulationinduced contractions were determined. Results: Expression of b1-, b2-and b3-adrenoceptor messenger ribonucleic acid in the human ureter was confirmed by reverse transcription polymerase chain reaction. Positive staining for b1-, b2-and b3-adrenoceptor was identified not only in smooth muscle, but also in the urothelium of the human ureter. All b-adrenoceptor agonists decreased the tone of KCl-induced contractions of the human ureter with a rank order of relaxant effects of isoproterenol > procaterol > TRK-380 > salbutamol > BRL 37344. Furthermore, isoproterenol, procaterol and TRK-380 significantly decreased the amplitude of electrical field stimulation-induced contractions with a rank order of inhibitory effects of isoproterenol > procaterol > TRK-380. Conclusions: Human ureteral relaxation is mediated by both b2-and b3-adrenoceptor stimulation. b3-Adrenoceptor agonists have the potential to relax the human ureter, and their clinical application in the treatment of ureteral stones is expected.

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“…Alertnative agents being studied included: α-adrenergic blocker tamsulosin, intranasal desmopressin, isosorbide dinitrate and nifedipine. [10][11][12][13][14][15][16][17] So far, there are only few studies in literature focusing on the effectiveness of anti-cholinergic medication used alone or in addition to NSAIDs or opiates for the treatment of RC.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Metoclopramide to Treat Pain and Nausea in Renal Colic Patients: A Prospective Randomised, Double-Blind, Controlled Trial

Kaya

Çevik

Acar

et al. 2015

Hong Kong Journal of Emergency Medicine

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Introduction:This study aimed to evaluate the clinical efficacy of intravenous metoclopramide for the relief of pain and nausea among the emergency department patients with renal colic. Methods: Patients were randomised into three groups: tenoxicam (20 mg); tenoxicam (10 mg) plus metoclopramide (10 mg); and metoclopramide (10 mg). Changes in pain and nausea were examined at the 10th, 20th and 30th minute after treatment. The development of side effects would be recorded. After the 30th minute, the need for additional pain and nausea relief was evaluated. Results: Totally 80 patients were enrolled in each group. There was significant mean pain score difference as measured by visual analog scale (VAS) from 0 minute to 10th, 20th and 30th minute post-treatment for all treatment groups (p<0.001). There was no significant difference in mean VAS decrease from 0 minute to the 30th minute: tenoxicam group: 36 mm [95% confidence interval (CI) 28-43 mm] vs. tenoxicam plus metoclopramide: 45 mm (95% CI 38-52 mm) vs. metoclopramide group: 37 mm (95% CI 30-45 mm) (p=0.163). Similarly, no significant differences in mean nausea scores between the three groups were demonstrated at the 10th, 20th and 30th minute after treatment (p=0.236, 0.330 and 0.652 respectively). After the 30th minute, 43 (53%) patients needed additional pain relieving agent in the tenoxicam group compared to 27 (33%) patients in the tenoxicammetoclopramide group and 33 (41%) patients in the metoclopramide group (p=0.030). No significant adverse drug reaction events were encountered. Conclusion: Metoclopramide is as effective as tenoxicam to treat pain and nausea for patients with renal colic in the emergency department. (Hong Kong j.emerg.med. 2015;22:93-99)

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A Systematic Review of Medical Therapy to Facilitate Passage of Ureteral Calculi

Cited by 20 publications

References 73 publications

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

Expression and functional role of β₃‐adrenoceptors in the human ureter

Clinical Efficacy of Metoclopramide to Treat Pain and Nausea in Renal Colic Patients: A Prospective Randomised, Double-Blind, Controlled Trial

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A Systematic Review of Medical Therapy to Facilitate Passage of Ureteral Calculi

Cited by 20 publications

References 73 publications

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

Expression and functional role of β3‐adrenoceptors in the human ureter

Clinical Efficacy of Metoclopramide to Treat Pain and Nausea in Renal Colic Patients: A Prospective Randomised, Double-Blind, Controlled Trial

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Expression and functional role of β₃‐adrenoceptors in the human ureter