Increasing the success rate of medical therapy for expulsion of distal ureteral stones using adjunctive treatment with calcium channel blocker

Skrekas, Thomas; Liapis, D.; Kalantzis, Athanasios; Argyropoulos, A.; Doumas, K.; Lycourinas, M.

doi:10.1016/s1569-9056(03)80323-8

Cited by 11 publications

(4 citation statements)

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“…It is beneficial to improve these modifiable factors so as to promote stone expulsion. Various medications, such as nifedipine (a calcium antagonist), glyceryl trinitrate, prostaglandin synthesis inhibitors, antibiotics, and corticosteroid agents (deflazacort, methylprednisolone) have been investigated as spasmolytic agents that would promote the expulsion of ureteral stones, both in watchful waiting patients and post‐ESWL patients 11–13 . Recently, alpha‐1 adrenergic blockers, which are used by urologists to treat lower urinary tract syndrome, have been noted to be useful.…”

Section: Discussionmentioning

confidence: 99%

Low dose tamsulosin for stone expulsion after extracorporeal shock wave lithotripsy: Efficacy in Japanese male patients with ureteral stone

et al. 2008

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Objective:We evaluated the efficacy of low dose tamsulosin after extracorporeal shock wave lithotripsy (ESWL) in Japanese male patients with ureteral stone. Methods: One hundred and two Japanese male patients with ureteral stones who underwent ESWL were randomly divided into three groups. Group A (38 patients) was given tamsulosin (0.2 mg/day); group B (30 patients) was given choreito, a herbal medicine (7.5 g/day); and group C (34 patients) received no medication. Stone clearance was assessed at 1, 7, 14, and 28 days after ESWL using plain abdominal radiography and abdominal ultrasonography. After 28 days, stone delivery was checked every 2 weeks. Results: The stone-free rate was 84.21%, 90%, and 88.24% for groups A, B, and C, respectively (P = 0.3425). The mean expulsion time was 15.66 Ϯ 6.14 days in group A, 27.74 Ϯ 25.36 days in group B, and 35.47 Ϯ 53.70 days in group C. The expulsion time of group A was significantly shorter than that of groups B (P = 0.0116) and C (P = 0.0424). Conclusions:The addition of tamsulosin to conservative treatment appeared to be effective in shortening the stone expulsion time.

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Section: Discussionmentioning

confidence: 99%

Low dose tamsulosin for stone expulsion after extracorporeal shock wave lithotripsy: Efficacy in Japanese male patients with ureteral stone

et al. 2008

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“…Five scientific assembly abstracts were included in the final analysis. 40,45,49,55,56 We attempted to contact the authors of these 5 abstracts but received no response at the time of article submission.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Nifedipine was the calcium channel blocker used in all 9 trials. 39,43,45,[52][53][54][55][56][57] All the trials allowed for pain medications (commonly nonsteroidal anti-inflammatory medications) and encouraged a minimum of 2 L of fluid intake per day.…”

Section: Study Characteristicsmentioning

confidence: 99%

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

Singh¹,

Alter²

2007

Academic Emergency Medicine

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Study objective: Acute renal colic is a common presenting complaint to the emergency department. Recently, medical expulsive therapy using ␣-antagonists or calcium channel blockers has been shown to augment stone passage rates of moderately sized, distal, ureteral stones. Herein is a systematic evaluation of the use of medical expulsive therapy to facilitate ureteral stone expulsion. Methods: We searched the databases of MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. Additional sources included key urologic journals and bibliographies of selected articles. We included studies that incorporated a randomized or controlled clinical trial design, patients older than 18 years, treatment in which an ␣-antagonist or calcium channel blocker was compared to a standard therapy group, and studies that reported stone expulsion rates. A random effects model was used to obtain summary risk ratios (RRs) and 95% confidence intervals (CIs) for stone expulsion rate. Results: A pooled analysis of 16 studies using an ␣-antagonist and 9 studies using a calcium channel blocker suggested that the addition of these agents compared to standard therapy significantly improved spontaneous stone expulsion (␣-antagonist RR 1.59; 95% CI 1.44 to 1.75; number needed to treat 3.3 [95% CI 2.1 to 4.5]; calcium channel blocker RR 1.50; 95% CI 1.34 to 1.68; number needed to treat 3.9 [95% CI 3.2 to 4.6]) in patients with distal ureteral stones. Subgroup analysis of trials using concomitant medications (ie, low-dose steroids, antibiotics, and elimination of trials using an anticholinergic agent) yielded a similar improvement in stone expulsion rate. Adverse effects were noted in 4% of patients receiving ␣-antagonist and in 15.2% of patients receiving calcium channel blockers. Conclusion: Our results suggest that "medical expulsive therapy," using either ␣-antagonists or calcium channel blockers, augments the stone expulsion rate compared to standard therapy for moderately sized distal ureteral stones. [

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Alpha-blockers as medical expulsive therapy for ureteral stones

Campschroer

Zhu

Vernooij

et al. 2014

Cochrane Database of Systematic Reviews

131

123

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Increasing the success rate of medical therapy for expulsion of distal ureteral stones using adjunctive treatment with calcium channel blocker

Cited by 11 publications

References 0 publications

Low dose tamsulosin for stone expulsion after extracorporeal shock wave lithotripsy: Efficacy in Japanese male patients with ureteral stone

Low dose tamsulosin for stone expulsion after extracorporeal shock wave lithotripsy: Efficacy in Japanese male patients with ureteral stone

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

Alpha-blockers as medical expulsive therapy for ureteral stones

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