Efficacy of Tamsulosin in the Management of Lower Ureteral Stones: A Randomized Double-blind Placebo-controlled Study of 100 Patients

Alobaidy, A.D.M.; Al‐Ansari, Abdulla; Al‐Naimi, Abdulla; Assadiq, Khalid; Azmi, M.D.; Shokeir, Ahmed A.

doi:10.1016/j.urology.2009.09.073

Cited by 92 publications

(90 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In another study involving 100 patients with stones of 10 mm (51 of them 5 mm) located below the common iliac vessels, patients were followed up until the passage of the stone, or for a maximum of four weeks, and the expulsion rate was reported to be 82% in the 0.4 mg tamsulosin group and 61% in the placebo group (p ¼ 0.02). 18 The expulsion time was 6.4 days in the tamsulosin group and 9.8 days in the placebo group, and the amount of analgesic agent used was 67.5 mg and 127.2 mg in the tamsulosin and placebo groups, respectively. In the tamsulosin group, side effects developed in 9 of 50 patients.…”

Section: Discussionmentioning

confidence: 97%

“…15 Since the first report on tamsulosin in 2002, 11 it has become a commonly used agent for MET. 9,11,[16][17][18][19] In a randomized double blind study consisting of 104 patients with stones located in the lower ureter, the expulsion rate was 80.4% in the 0.4 mg tamsulosin group and 62.8% in the control group. The authors concluded that a 1 adrenergic receptor blockers potentiated the spasmo-analgesic action of drugs used in standard methods of treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

et al. 2014

View full text Add to dashboard Cite

We evaluated the efficacy of tamsulosin and nifedipine in medical expulsive therapy (MET) in patients with distal ureteral stone. In addition, we tried to determine the predictive value of Hounsfield Unit (HU) of the stone in the success of MET. A total of 75 patients with a distal ureteral stone of 5-10 mm diameter were randomly divided into three groups. Group 1 (n ¼ 25) received tamsulosin 0.4 mg/d; group 2 (n ¼ 25) received nifedipine 10 mg/day p.o and group 3 (n ¼ 25) received diclofenac sodium 50 mg p.o. when required. At the beginning of each treatment, the HU of the stone was also measured using a non-contrast computerized tomography in all the patients. The results were evaluated at week four. The mean age of the patients was 36.8 (range, 16-68) years. Stone expulsion was observed in 19 (76%) patients in group 1, 16 (64%) patients in group 2 and 9 (36%) patients in group 3 (p group1-3 ¼ 0.004, p group2-3 ¼ 0.048 and p group1-2 ¼ 0.355). The mean expulsion time was 9, 9.1 and 10.3 d, respectively (p group1-3 50.001, p group2-3 50.001 and p group1-2 ¼ 0.619). The mean diclofenac sodium dose per patient was 544, 602 and 1408 mg in groups 1, 2 and 3, respectively (p group1-3 50.001, p group2-3 50.001 and p group1-2 ¼ 0.977). The mean HU of the stone in patients with and without a successful MET was 363 and 389, respectively (p ¼ 0.462). Our results showed that MET with both nifedipine and tamsulosin provided a similar increase in the expulsion rate for distal ureteral stones. HU does not seem to be a predictive parameter for stone expulsion.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

et al. 2014

View full text Add to dashboard Cite

show abstract

“…a-ARs augment contractions and the clinically used a 1 -AR blocker tamsulosin can reduce or block human ureteric contraction (18). Likewise, the a 1 -AR blocker doxazosin also inhibits spontaneous contractions in human ureteral strips and both drugs have found clinical use in assisting ureteral stone passage through the relative relaxant effects (19,20). By contrast, b-ARs enhance ureteral wall relaxation.…”

Section: Neurogenic Contractilitymentioning

confidence: 99%

Control of Urinary Drainage and Voiding

Hill

2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Urine differs greatly in ion and solute composition from plasma and contains harmful and noxious substances that must be stored for hours and then eliminated when it is socially convenient to do so. The urinary tract that handles this output is composed of a series of pressurizable muscular compartments separated by sphincteric structures. With neural input, these structures coordinate the delivery, collection, and, ultimately, expulsion of urine. Despite large osmotic and chemical gradients in this waste fluid, the bladder maintains a highly impermeable surface in the face of a physically demanding biomechanical environment, which mandates recurring cycles of surface area expansion and increased wall tension during filling, followed by rapid wall compression during voiding. Afferent neuronal inflow from mucosa and submucosa communicates sensory information about bladder fullness, and voiding is initiated consciously through coordinated central and spinal efferent outflow to the detrusor, trigonal internal sphincter, and external urethral sphincter after periods of relative quiescence. Provocative new findings suggest that in some cases, lower urinary tract symptoms, such as incontinence, urgency, frequency, overactivity, and pain may be viewed as a consequence of urothelial defects (either urothelial barrier breakdown or inappropriate signaling from urothelial cells to underlying sensory afferents and potentially interstitial cells). This review describes the physiologic and anatomic mechanisms by which urine is moved from the kidney to the bladder, stored, and then released. Relevant clinical examples of urinary tract dysfunction are also discussed.

show abstract

“…(17) In patients presenting with DUS of 610 mm without the use of MET, the reported spontaneous stone clearance rates are between 35.2% and 61% with mean expulsion times ranging between 9.87 and 24.5 days. (18)(19)(20)(21) Several factors can affect spontaneous stone clearance of DUS including: stone size, site, number and also the presence or absence of ureteric smooth muscle spasm and/or submucosal oedema. Coll et al found a direct relationship between stone size and spontaneous clearance.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study Comparing Tamsulosin and Silodosin in Medical Expulsive Therapy for Lower Ureteric Stones

Reddy¹,

Prathvi²,

Kulshreshtha³

et al. 2016

jemds

View full text Add to dashboard Cite

The urinary stone disease is one of the most common afflictions of the modern society and it has been described since antiquity with the westernization of global culture. The efficacy of mini-invasive therapies, such as Extracorporeal Shock Wave Lithotripsy [ESWL] and ureteroscopy are not risk free, are problematic and are quite expensive. Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitate stone expulsion. MATERIALS AND METHODSThis prospective randomised study was conducted between September 2015 and May 2016 at Rajarajeshwari Medical College and Hospital, Bangalore. The cohort comprised 100 adult patients (54 men and 46 women) who presented with a symptomatic, unilateral, single, uncomplicated lower ureteric stone of ≤ 10 mm. Patients were randomized into two equal groups, 50 (50%) patients received a daily single dose of tamsulosin 0.4 mg for 28 days and 50 (50%) patients received a daily single dose of silodosin 8 mg for 28 days. Both groups were compared in terms of patient's demographics, socioeconomic status, stone size and side, type of MET, stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use and incidence of side effects. Subgroup analysis was performed according to stone size ≤ or > 5 mm. RESULTSNo significant differences among the two groups for patient's age, gender, stone side and stone size. Spontaneous stone expulsion rate within 28 days was observed in 44 (88%) patients in the tamsulosin group and in 45 (90%) patients in the silodosin group without statistically significant differences. There were no statistically significant differences observed in terms of mean expulsion time, mean number of pain episodes and need for analgesics. Retrograde ejaculation was significantly higher in the silodosin arm, while the incidence of side effects related to peripheral vasodilation were higher in the tamsulosin arm, but it was statistically insignificant. CONCLUSIONTamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associated with a lower incidence of side effects related to peripheral vasodilation, but a higher incidence of retrograde ejaculation when compared to tamsulosin. However, a multicentre study on a larger scale is needed to evaluate the current medicines. KEYWORDSTamsulosin, Silodosin, Stone Expulsion Rate, Medical Expulsion Therapy (MET). Financial or Other, Competing Interest: None. Submission 18-06-2016, Peer Review 13-07-2016, Acceptance 18-07-2016, Published 25-07-2016. Corresponding Author: Dr. Sreedhar Reddy, Professor and HOD, Department of Urology Raja Rajeshwari Medical College and Hospital, Bangalore. E-mail: urologyreddy@yahoo.com DOI: 10.14260/jemds/2016 Nevertheless these techniques are not risk free, are problematic and are quite expensive. (4) Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitat...

show abstract

Efficacy of Tamsulosin in the Management of Lower Ureteral Stones: A Randomized Double-blind Placebo-controlled Study of 100 Patients

Cited by 92 publications

References 14 publications

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

Control of Urinary Drainage and Voiding

A Prospective Study Comparing Tamsulosin and Silodosin in Medical Expulsive Therapy for Lower Ureteric Stones

Contact Info

Product

Resources

About