Efficacy and safety of tamsulosin vs. alfuzosin as medical expulsive therapy for ureteric stones

Ibrahim, Ahmad; Mahmood, Isam Hamo; Mahmood, Nada S.

doi:10.1016/j.aju.2013.02.003

Cited by 20 publications

(20 citation statements)

References 18 publications

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“…As to safety, both combinations were well tolerated by the patients. Ibrahim et al [21] similarly reported minor therapy-related side-effects in five patients taking tamsulosin and in six taking alfuzosin, which were mild and did not require the withdrawal of treatment in any patient. Patients who were not stone-free after the 4 weeks of follow-up were treated successfully with ureteroscopy.…”

Section: Discussionmentioning

confidence: 87%

The efficacy of tamsulosin vs. nifedipine for the medical expulsive therapy of distal ureteric stones: A randomised clinical trial

Gandhi

Agrawal

2013

Arab Journal of Urology

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ObjectivesTo assess and compare, in a randomised clinical trial, the efficacy of tamsulosin and nifedipine as medical expulsive therapy for distal ureterolithiasis.Patients and methodsIn all, 128 symptomatic patients with stones in the juxtavesical tract of the ureter were randomly divided into group 1 (64 patients) receiving oral nifedipine sustained-release 30 mg/day, and group 2 (64 patients) receiving tamsulosin 0.4 mg/day. Both groups received oral prednisolone 30 mg/day for 10 days and diclofenac 75 mg intramuscularly on demand. Patients were assessed by weekly ultrasonography with or with no abdominal computed tomography, during a follow-up of 4 weeks. The stone passage rate and time, analgesic use, hospitalisation and endoscopic interventions were evaluated. The results were analysed statistically using appropriate tests.ResultsThe stone expulsion rate was 55% for group 1 and 80% for group 2 (P = 0.004). The mean stone size was 8.59 and 8.85 mm in groups 1 and 2, respectively. The mean expulsion time was 23 days for group 1 and 9 days for group 2 (P < 0.001). The mean number of diclofenac injections was 1.19 for group 1 and 0.42 for group 2 (P < 0.001). Eleven patients in group 1 vs. two in group 2 were hospitalised (P = 0.001). Twenty-six patients in group 1 and 13 in group 2 underwent ureteroscopy (P < 0.001).ConclusionsMedical expulsive therapy with tamsulosin should be considered as a first-line treatment for index cases of distal ureterolithiasis with no complications. The use of tamsulosin provides better stone expulsion than does nifedipine.

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Section: Discussionmentioning

confidence: 87%

The efficacy of tamsulosin vs. nifedipine for the medical expulsive therapy of distal ureteric stones: A randomised clinical trial

Gandhi

Agrawal

2013

Arab Journal of Urology

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“…Results of quality assessment using the Cochrane Risk of Bias tool can be found in Figure 7. Overall, a high degree of bias was seen with only nine studies judged to be at low risk while 41 were judged to be intermediate risk and 17 high risk . The most common cause for bias was blinding of both participants and personnel and outcomes assessment.…”

Section: Resultsmentioning

confidence: 99%

Alpha blockers in the management of ureteric lithiasis: A meta-analysis

Raison

Ahmed

2017

Int J Clin Pract

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“…Medical expulsive therapy proved to facilitate passage for stones less than 10 mm along the whole ureter. [ 13 ] On the other hand, URS and SWL are currently the main interventional treatment options for symptomatic ureteral stones. Although URS is a more invasive option than SWL, it has a better success rate with an overall success rate extending from 85.6%[ 14 ] to 95.7%.…”

Section: Discussionmentioning

confidence: 99%

Reporting ureteroscopy complications using the modified clavien classification system

Ibrahim

2015

Urol Ann

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Objective:Perioperative complications are one of the surrogate indicators of surgical outcomes. However, reporting these complications need a precise grading system. Our aim is to report and grade the complications of semirigid ureteroscopy in ureteral stone management according to the modified Clavien classification system.Materials and Methods:This is a prospective study conducted From January 2012 to June 2013. All patients with ureteral stones who were indicated for semirigid URS were evaluated. All procedures were performed by the same surgeon. The data recorded including patient demographics, clinical indication, stone size and location, operative time and complications were classified according to the modified Clavien classification system. The patients were followed for 8 weeks postoperatively.Results:148 patients included, Stone distribution was: 89 (60.1%) lower ureteral, 26 (17.6%) mid ureteral, and 33 (22.3%) upper ureteral. the mean stone size was 8.6 mm. Urgent URS done in 23% of patient. The overall stone free rate was 88.5%, the individual stone free rate for the upper, middle and lower ureter were 87.9%, 84.6%, and 89.9%, respectively. The mean operative time was 31.9 min (20-50 min.). Complications occurred in 26.35% of patients. Grade I complications occurred in 32 patients (26.1%), grade II in 9 (6.1%), grade IIIa in 7 (4.7%), grade IIIb in 8 (5.4%), grade IVa in two patient (1.35%), and grade IVb in one patient (0.7%). No grade V complication was encountered.Conclusion:Ureteroscopy becomes the vanguard interventional therapy for ureteral stones with well-established efficacy and safety. It is of paramount importance to adopt a precise structured classification system for reporting surgical complications, that should be flexible and comprehensive in order to accommodate the various and rapidly expanding surgical fields.

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Efficacy and safety of tamsulosin vs. alfuzosin as medical expulsive therapy for ureteric stones

Cited by 20 publications

References 18 publications

The efficacy of tamsulosin vs. nifedipine for the medical expulsive therapy of distal ureteric stones: A randomised clinical trial

The efficacy of tamsulosin vs. nifedipine for the medical expulsive therapy of distal ureteric stones: A randomised clinical trial

Alpha blockers in the management of ureteric lithiasis: A meta-analysis

Reporting ureteroscopy complications using the modified clavien classification system

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