Alfuzosin Stone Expulsion Therapy for Distal Ureteral Calculi: A Double-Blind Placebo- Controlled Study

Does tamsulosin increase stone clearance after shockwave lithotripsy of renal stones? A prospective, randomized controlled study

“…Recently, many agents have been used to facilitate stone passage along the ureter with or without SWL. Among these agents a-blockers have proven effective in facilitating stone passage [3][4][5][6][7][8].…”

Medical expulsive therapy for ureteral stones

“…[28] Diğer randomize, plasebo kontrollü çalışmada ise tamsulosin ve plasebonun etkinlikleri karşılaştırılmıştır. Bunun istisnası olan üç çalışma vardır.…”

Medical expulsive therapy is an effective treatment for small distal ureteral stones

“…Nifedipine (40 mg/d [7] or 30 mg/d extended release [8][9][10][11][12] ) Alfuzosin (dosage not reported) [13] Doxazosin (4 mg) [14,15] Tamsulosin (0.4 mg/d) [14,[16][17][18][19] Terazosin (5 mg/d) [14,19] Clinical trial design and details Randomized [7][8][9]11,12] or nonrandomized [10] No. of pts per treatment group: 25-70 Mean stone size: 3.9-12.8 mm; stone location generally distal Nifedipine recipients also received concomitant methylprednisolone, [7] ketorolac, [8] deflazacort [9,11,12] or prednisolone [10] Control groups received the same adjunctive drug with [7] or without placebo [8,10,12] (one study control was prednisolone and ketorolac, [8] another was phloroglucinol and deflazacort [12] ); in other studies they were just labelled as controls [9,11] Randomized [13][14][15][16][17][18][19] No.…”

“…of pts per treatment group: 25-70 Mean stone size: 3.9-12.8 mm; stone location generally distal Nifedipine recipients also received concomitant methylprednisolone, [7] ketorolac, [8] deflazacort [9,11,12] or prednisolone [10] Control groups received the same adjunctive drug with [7] or without placebo [8,10,12] (one study control was prednisolone and ketorolac, [8] another was phloroglucinol and deflazacort [12] ); in other studies they were just labelled as controls [9,11] Randomized [13][14][15][16][17][18][19] No. of pts per treatment group: 15-50 Mean stone size: 3.0-7.8 mm Pts received a-blockers with [14][15][16][17][18][19] or without [13] standard treatment (diclofenac, [15,16] tenoxicam, [14,17] diclofenac plus horse chestnut extract, [18] or ketorolac plus buprenorphine [19] ) Control groups received standard treatment [14][15][16][17][18][19] or placebo [13] Clinical trial results (investigative drug vs control)…”

“…Increased expulsion rate (60-89% vs 35-64%; significant between-group difference in most studies [7][8][9]12] ) Reduced time to expulsion (5-12.6 vs 5-20 d; significant between-group difference in most studies [7,9,11,12] ) Significantly reduced number of work days lost (1.76 vs 4.96 d) [8] Significantly reduced dosages of adjunctive analgesics [9,11] Increased expulsion rate (53-90% vs 20-77%; significant between-group difference in most trials [14,15,18,19] ) Reduced time to expulsion (4.4-7.6 vs 7.5-12.1 d; significant between-group difference in most trials [13][14][15]18,19] ) Reduced the number of colic episodes, pain and use of analgesics [14] Tolerability Generally well tolerated Adverse events included nausea/vomiting, asthenia, dyspepsia, headache, euphoria, drowsiness and hypotension Generally well tolerated Adverse events included dizziness, headache, nausea, vomiting, diarrhoea and hypotension…”