Tamsulosin does not have greater efficacy than conventional treatment for distal ureteral stone expulsion in Mexican patients

Ochoa-Gómez, Raúl; Prieto-Díaz-Chávez, Emilio; Trujillo-Hernández, Benjamı́n; Vásquez, Clemente

doi:10.1007/s00240-011-0380-z

Cited by 19 publications

(24 citation statements)

References 28 publications

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“…Se incluyeron 10 estudios 14,17,19,24,25,27,32,35,38,42 y 729 participantes en el metaaná lisis de efectos aleatorios para cualquier evento adverso en los pacientes tratados con tamsulosina (frente el grupo comparació n); mostraron un pool de RR de 1,79 (IC 95% 1,19-2,71; I 2 = 0). No se observó heterogeneidad entre los estudios (I 2 = 0%).…”

Section: Efectos Adversos De Tamsulosina: Metaanálisisunclassified

Eficacia y seguridad de tamsulosina para el tratamiento conservador del cólico nefrítico: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados

et al. 2015

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Section: Efectos Adversos De Tamsulosina: Metaanálisisunclassified

Eficacia y seguridad de tamsulosina para el tratamiento conservador del cólico nefrítico: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados

et al. 2015

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“…Since the last published meta-analysis, we found and included 10 additional studies. 14,[21][22][23][24][25][26][27]33,35 To compare these previous meta-analyses and evaluate differences, our study reported the results in two ways: the 10 most recent studies since the last meta-analysis and the combined results. 8 Our study focused solely on tamsulosin for distal ureterolithiasis and not all a-antagonists, as previously published by Seitz and colleagues, Hollingsworth and colleagues, Singh and colleagues, and Parsons and colleagues.…”

Section: Discussionmentioning

confidence: 99%

“…Only 4 studies had a low risk of bias, 14,27,33,36 7 had a moderate risk of bias, 24,25,30,32,34,35,38,40 and 11 had a high risk of bias 23,26,28,29,31,37,39,[41][42][43] (Figure 2). A poor description of the randomization process is mainly responsible for the high proportion of moderate or high risk of bias studies.…”

Section: Methodological Qualitymentioning

confidence: 99%

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Tamsulosin for treatment of unilateral distal ureterolithiasis: a systematic review and metaanalysis

Malo

Audette-Côté

Émond

et al. 2014

CJEM

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Objectives: The lifetime prevalence of ureterolithiasis is approximately 13% for men and 7% for women in the United States. Tamsulosin, an a-antagonist, has been used as therapy to facilitate the expulsion of lithiasis. Whether it is a good treatment for distal lithiasis remains controversial. We conducted a systematic review and meta-analysis to evaluate the effect of tamsulosin on the passage of distal ureterolithiasis. Methods: A systematic search was conducted using MEDLINE, EMBASE, and Cochrane Central. Trial eligibility was evaluated by two investigators. All randomized controlled trials (RCTs) comparing tamsulosin to standard therapy or placebo for the treatment of a single distal ureterolithiasis # 10 mm in adult patients with renal colic confirmed by radiographic imaging were included. Data extraction was conducted in duplicate. Primary outcome was the expulsion rate, and secondary outcomes were the mean time for ureterolithiasis expulsion, analgesic requirements, and side effects. Mantel-Haenszel random effect models were used, and heterogeneity was assessed using I 2 statistics. Data were presented with relative risks (RRs). Results: The search strategy identified 685 articles, of which 22 studies were included. Combined results suggested a benefit for the expulsion of ureterolithiasis (# 10 mm) when tamsulosin was used compared to a standard treatment (RR 1.50 [95% CI 1.31-1.71], I 2 5 70%). A decrease in the average time of expulsion of the ureterolithiasis of 3.33 days in favour of tamsulosin was observed (95% CI 24.23, 22.44], I 2 5 67%). Conclusion: Tamsulosin increases the rate of spontaneous passage of distal ureterolithiasis (# 10 mm). RÉ SUMÉObjectif: La pré valence de la lithiase uré té rale au cours de la vie est d'environ 13% chez les hommes et 7% chez les femmes aux É tats-Unis. La tamsulosine, un alpha-bloquant, est utilisé e comme traitement pour faciliter l'expulsion des calculs; toutefois, le recours à ce traitement dans la lithiase distale fait l'objet de controverse. Nous avons donc mené un examen mé thodique et une mé ta-analyse afin d'é valuer l'effet de la tamsulosine sur le passage des lithiases uré té rales distales. Mé thode: Une recherche mé thodique a é té effectué e dans les bases de donné es MEDLINE, EMBASE, et Cochrane Central, et l'acceptabilité des essais a é té soumise à l'examen de deux chercheurs. Ont é té retenus tous les essais comparatifs, à ré partition alé atoire, visant à mettre en parallè le la tamsulosine avec les procé dé s thé rapeutiques habituels ou avec un placé bo dans le traitement d'une seule lithiase uré té rale distale,# 10 mm, confirmé e à la radiographie, chez des adultes souffrant de colique né phré tique. L'extraction des donné es a é té ré alisé e en double. Le principal critè re d'é valuation é tait le taux d'expulsion, et les critè res d'é valuation secondaires portaient sur le temps moyen é coulé avant l'expulsion des lithiases uré té rales, l'administration d'analgé siques, et les effets indé sirables. Nous avons eu recours aux modè...

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“…Five studies were duplicates, 5 did not contain sufficient data to analyze in a meta-analysis, and 1 reported 1-week outcomes (versus 3-to 4-week outcomes). Authors for 7 studies were contacted for additional information, 8,[17][18][19][20][21][22] and complete data were available in only 8 cases. Agreement between study abstractors was excellent (Cohen's k¼0.94 [95% CI 0.82 to 1.0]).…”

Section: Resultsmentioning

confidence: 99%

Effect of Tamsulosin on Stone Passage for Ureteral Stones: A Systematic Review and Meta-analysis

Wang

Smith‐Bindman

Whitaker

et al. 2017

Annals of Emergency Medicine

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Twitter: @ralphcwang.Study objective: Tamsulosin is recommended for patients receiving a diagnosis of a ureteral stone less than 10 mm who do not require immediate urologic intervention. Because of conflicting results from recent meta-analyses and large randomized controlled trials, the efficacy of tamsulosin is unclear. We perform a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone.Methods: MEDLINE, EMBASE, and CENTRAL databases were searched without language restriction through November 2015 for studies assessing the efficacy of tamsulosin and using a double-blind, randomized, controlled trial design. Meta-analysis was conducted with a random-effects model and subgroup analyses were conducted to determine sources of heterogeneity.Results: Eight randomized controlled trials (N¼1,384) contained sufficient information for inclusion. The pooled risk of stone passage in the tamsulosin arm was 85% versus 66% in the placebo arm, but substantial heterogeneity existed across trials (I 2 ¼80.2%; P<.001). After stratifying of studies by stone size, the meta-analysis of the large stone subgroup (5 to 10 mm; N¼514) indicated a benefit of tamsulosin (risk difference¼22%; 95% confidence interval 12% to 33%; number needed to treat¼5). The meta-analysis of the small stone subgroup (<4 to 5 mm; N¼533) indicated no benefit (risk difference¼-0.3%; 95% confidence interval -4% to 3%). Neither meta-analysis for the occurrence of dizziness or hypotension showed a significant effect. Conclusion:Tamsulosin significantly improves stone passage in patients with larger stones, whereas the effect of tamsulosin is diminished in those with smaller stones, who are likely to pass their stone regardless of treatment.

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Tamsulosin does not have greater efficacy than conventional treatment for distal ureteral stone expulsion in Mexican patients

Cited by 19 publications

References 28 publications

Eficacia y seguridad de tamsulosina para el tratamiento conservador del cólico nefrítico: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados

Eficacia y seguridad de tamsulosina para el tratamiento conservador del cólico nefrítico: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados

Tamsulosin for treatment of unilateral distal ureterolithiasis: a systematic review and metaanalysis

Effect of Tamsulosin on Stone Passage for Ureteral Stones: A Systematic Review and Meta-analysis

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