Adjunctive Tamsulosin Improves Stone Free Rate After Ureteroscopic Lithotripsy of Large Renal and Ureteric Calculi: A Prospective Randomized Study

John, Tony T.; Razdan, Sanjay

doi:10.1016/s0022-5347(08)61468-8

Cited by 7 publications

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“…In a prospective, randomized study, 78 patients with renal and ureteral calculi ranging in size from 1-2 cm in diameter were treated ureteroscopically. Those patients treated with tamsulosin had improved stone-free rates on postoperative computed tomography scans and also had fewer episodes of postoperative ureteral colic, defined by episodes of flank pain requiring narcotics, emergency room visit or inpatient admission [13]. As previous studies have also demonstrated the benefits of using tamsulosin after SWL, one should consider the routine use of this medication after flexible ureteroscopic management of renal calculi.…”

Section: Medical Expulsive Therapy As Adjunctive Therapy After Uretermentioning

confidence: 95%

Modern applications of ureteroscopy for intrarenal stone disease

Wang

Preminger

2011

Current Opinion in Urology

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Section: Medical Expulsive Therapy As Adjunctive Therapy After Uretermentioning

confidence: 95%

Modern applications of ureteroscopy for intrarenal stone disease

Wang

Preminger

2011

Current Opinion in Urology

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“…Tamsulosin has also been used as an adjunct to ureterorenoscopic (URS) lithotripsy of large renal and ureteric stones. John and Razdan [46] reported a significantly higher stone‐free rate and lower pain episodes at 4 weeks in these cases.…”

Section: Metsmentioning

confidence: 69%

Medical therapy for calculus disease

2011

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What's known on the subject? and What does the study add? Current knowledge on the subject of "medical stone management" is available in fractionated form. This study is a comprehensive and critical review of the literature and provides up-to-date information on the subject in concise and precise manner. The study highlights the role of medical therapy in various aspects of stone management, i.e. clearance of existing calculi by medical dissolution and facilitating expulsion, and prevention of recurrence.Urolithiasis is a common problem with a high recurrence rate. Medical therapy directed to relieve agonizing pain, expulsion of stone, dissolution of uric acid and cystine stone and prevention of recurrence. NSAIDs are superior to opioids for renoureteral colic because their use doesn't induce vomiting and there is lesser requirement of rescue analgesia. In randomized trials, anticholinergics were not found to be beneficial. Alpha blockers, particularly tamsulosin, reduce pain and facilitate expulsion of stone and fragments of stone following extracorporeal shock wave lithotripsy (SWL) and ureterorenoscopic lithotripsy. Potassium citrate helps in chemodissolution of uric acid and cystine stones and is useful in prevention of stone recurrence in general and in those who have undergone SWL or percutaneious nephrolithotomy. Other measures for prevention of stone recurrence include fluid and dietary therapy, counteracting underlying metabolic abnormalities using suitable medications, phytotheurapeutic agents and probiotics. Once the role of nanobacteria is established in genesis of urinary stones, anti-nanobacteria therapy holds the promise of opening new horizons for prevention of urinary stones. KEYWORDS calculus, colic, litholysis, medical expulsive therapy, medical management, probioticsINTRODUCTION Urolithiasis is a painful and costly condition compounded by a high recurrence rate [1][2][3][4]. It affects 5-15% of the population worldwide [5] with the recurrence rate close to 50% over 10 years [6]. It has associated morbidity and contributes to chronic kidney disease and even death. Advancements in the techniques of shock wave lithotripsy (SWL) and endourological procedures have rendered open stone surgery almost obsolete. Medical measures have assumed an important role in overall management of urolithiasis. Several medications [7] and dietary measures [8,9] have been shown to reduce the rate of stone recurrence. Indeed, a meta-analysis of randomized trials showed a 22.6% reduction in risk of stone recurrence with medicinal and dietary therapy [7]. With better understanding of pathophysiology of urinary stone disease, physicochemical character of urine and pharmacophysiology of the ureter, it is possible to treat selected patients with urolithiasis with only medical therapy. Medical measures are undertaken for renal and ureteric colic, medical expulsive therapy (MET) and chemolytic therapy. In a large proportion of patients, stone recurrence can be prevented by targeted medical therapy. Potential measures for pr...

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“…The most commonly studied primary endpoint was clearance or expulsion rate, which was successful passing of the stone. [8][9][10][11][12][13][14][15][16][17][18][19][20][21] A summary of studies can be found in Table 2.…”

Section: Summary Of Studiesmentioning

confidence: 99%

Efficacy and Safety of Alpha-Blockers for Kidney Stones in Adults

Koski

Zufall

2017

Journal of Pharmacy Technology

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Kidney stones are a common and growing problem in the United States. A recent survey found that 11% of men and 7% of women will experience at least one kidney stone in their lifetime. Recurrence is estimated to be ≤50% at 5 years. Risk factors include male gender, obesity, diabetes, gout, and income less than $75 000. Noncontrast computed tomography imaging is typically used to confirm diagnosis and estimate stone size. Pain is the most common symptom and occurs when the stone attempts to pass through the ureter. Kidney stones are often asymptomatic while growing and may take up to several months to grow to a detectable size. 1-3 Treatment of kidney stones depends on factors such as stone size and symptoms. Waiting for a stone to pass spontaneously is the recommended treatment for stones <5 mm with little to no pain. Management options for larger and painful stones include shockwave lithotripsy (SWL), ureteroscopy, surgical removal, and pharmacologic therapy. While the traditional role of pharmacologic therapy is for symptomatic relief or to prevent recurrence, some studies suggest using medications to promote the passage of stones and shorten the time it takes to pass the stone spontaneously. This is referred to as medical expulsive therapy (MET) and is where the use of alpha-blockers has been studied. MET can be used as monotherapy, post-lithotripsy, or with additional pharmacologic therapy. 2 A 2002 to 2009 survey found that MET use was infrequent before 2007, and from 2007 to 2009, it was prescribed in 14% of emergency department urolithiasis visits. 3 This article compiles and briefly reviews the studies, including metaanalyses, that examined the efficacy and safety of alphablockers as MET in the treatment of kidney stones.

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Adjunctive Tamsulosin Improves Stone Free Rate After Ureteroscopic Lithotripsy of Large Renal and Ureteric Calculi: A Prospective Randomized Study

Cited by 7 publications

References 0 publications

Modern applications of ureteroscopy for intrarenal stone disease

Modern applications of ureteroscopy for intrarenal stone disease

Medical therapy for calculus disease

Efficacy and Safety of Alpha-Blockers for Kidney Stones in Adults

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