Naftopidil <i>vs</i> silodosin in medical expulsive therapy for ureteral stones: A randomized controlled study in Japanese male patients

Tsuzaka, Yasuo; Matsushima, Hisashi; Kaneko, Tomoyuki; Yamaguchi, Tsuyoshi; Homma, Yukio

doi:10.1111/j.1442-2042.2011.02850.x

Cited by 39 publications

(37 citation statements)

References 16 publications

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“…Tatemichi et al [10] reported that in hamster ureter, ureteral contraction was mediated mainly by alpha-1A adrenoreceptor even though alpha-1D receptor are more prevalent so we used silodosin which is highly selective alpha-1A adrenoceptor antagonist and has 56 fold affinity for alpha-1A over alpha-1D adrenoceptor. [11,12] Gratzke et al [13] demonstrated the effectiveness of PDE 5 inhibitors vardenafil, sildenafil, and tadalafil in relaxation of ureteral smooth muscle in order of decreasing potency. [14,15] As tadalafil is more selective PDE-5i receptor as compared to sildenafil, visual problems are less likely.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in the management of ureteral stone: A prosective randomized trial

Bhattar¹,

Jain²,

Tomar³

et al. 2017

Turkish Journal of Urology

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Objective: To evaluate the safety and efficacy of silodosin and tadalafil in ease of negotiation of large size ureteroscope (8/9.8 Fr) in the management of ureteral stone. Material and methods:Between June 2015 and May 2016, 86 patients presented with ureteral stone of size 6-15 mm were on consent randomly assigned to 1 of 3 outpatient treatment arms: silodosin (Group A), tadalafil (Group B), and placebo (Group C). After two weeks of therapy 67 patients underwent ureteroscopy, and ureteral orifice configuration, ureteroscopic negotiation, ureteral dilatation, operating time, procedural complication and drug related side effects were noted in each group.Results: Ureteral negotiation was significantly better in Groups A (73.9%) and B (69.6%) as compared to Group C (38.1%) (p<0.01). Statistically significant difference was noted in the requirement for dilatation in Group C (71.4%) as compared to Groups A (26.1%) and B (39.1%) (p<0.01). Ureteral orifice was found to be more dilated in Groups A (69.6%) and B (60.9%) as compared to Group C (28.6%). Mean operating time was statistically lower in Groups A (35.2 min) and B (34.91 min) as compared to Group C (41.14 min) (p<0.01). Conclusion:Both silodosin and tadalafil not only relax ureteral smooth muscle but also help in forward propagation of large size ureteroscope (8/9.8 Fr) without any significant risk of adverse events.Keywords: Silodosin; tadalafil; ureteral stone; ureteroscope; ureteral orifice.Cite this article as: Bhattar R, Jain V, Tomar V, Yadav SS. Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in management of ureteral stone: A prosective randomized trial. Turk J Urol 2017; 43(4): 484-9

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in the management of ureteral stone: A prosective randomized trial

Bhattar¹,

Jain²,

Tomar³

et al. 2017

Turkish Journal of Urology

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“…[8][9][10][11] Tamsulosin, doxazosin, alfuzosin, silodosin, nifedipine and naftopidil are the most commonly used drugs in MET. 8,10,12 In this study, we compared the efficacy of tamsulosin and nifedipine in MET for distal ureteral stones in patients with renal colic. In addition, during these treatment modalities, we evaluated the value of Hounsfield Unit (HU) of the stone detected in a non-contrast computerized tomography (NCCT) in the prediction of MET success rate.…”

Section: Introductionmentioning

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

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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.

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“…(15) Tsuzaka compared the efficacy of the selective α1D AR antagonist naftopidil and the selective α1A AR antagonist silodosin in the management of symptomatic ≤10 mm ureteral stones. (16) Vittorio Imperatore et al, compared for the first time tamsulosin and silodosin in the context of MET for distal ureteric stones. (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.…”

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

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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...

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Naftopidil vs silodosin in medical expulsive therapy for ureteral stones: A randomized controlled study in Japanese male patients

Cited by 39 publications

References 16 publications

Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in the management of ureteral stone: A prosective randomized trial

Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in the management of ureteral stone: A prosective randomized trial

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

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

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