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Everaert K, Holm-Larsen T, Bou Kheir G, Rottey S, Weiss JP, Vande Walle J, Kabarriti AE, Dossche L, Hervé F, Spinoit AF, Nørgaard JP, Juul KV. Potential clinical applications of current and future oral forms of desmopressin (Review). Exp Ther Med 2024; 28:303. [PMID: 38873038 PMCID: PMC11170333 DOI: 10.3892/etm.2024.12592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/06/2024] [Indexed: 06/15/2024] Open
Abstract
Desmopressin is a synthetic analogue of vasopressin and a selective vasopressin receptor 2 agonist. It was first synthesised in 1967 and utilised for its antidiuretic properties. It is also used in bleeding disorders to enhance clotting. Other potential uses of the drug have been reported. The present review aims to provide a broad overview of the literature on potential further uses of oral forms of desmopressin. Key therapeutic areas of interest were identified based on known physiological activities/targets of desmopressin or reports of an effect of desmopressin in the literature. The feasibility of adequate dosing with oral forms of the drug was also considered. Systematic literature searches were carried out using the silvi.ai software for the identified areas, and summaries of available papers were included in tables and discussed. The results of the searches showed that desmopressin has been investigated for its efficacy in a number of areas, including bleeding control, renal colic, the central nervous system and oncology. Evidence suggests that oral desmopressin may have the potential to be of clinical benefit for renal colic and bleeding control in particular. However, further research is needed to clarify its effect in these areas, including randomised controlled studies and studies specifically of oral formulations (and doses). Further research may also yield findings for cancer, cognition and overactive bladder.
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Affiliation(s)
- Karel Everaert
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University Hospital, 9000 Ghent, Belgium
| | - Tove Holm-Larsen
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University Hospital, 9000 Ghent, Belgium
| | - George Bou Kheir
- Department of Urology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Sylvie Rottey
- Drug Research Unit and Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jeffrey P. Weiss
- Department of Urology, State University of New York Downstate Health Sciences University, New York City, NY 11203, USA
| | - Johan Vande Walle
- Department of Pediatric Nephrology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Abdo E. Kabarriti
- Department of Urology, State University of New York Downstate Health Sciences University, New York City, NY 11203, USA
| | - Lien Dossche
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics, Ghent University Hospital, 9000 Ghent, Belgium
| | - François Hervé
- Department of Urology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Anne-Françoise Spinoit
- Department of Pediatric & Reconstructive Urology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jens Peter Nørgaard
- Research & Development, Ferring Pharmaceuticals A/S, Ferring International PharmaScience Center, 2770 Copenhagen, Denmark
| | - Kristian Vinter Juul
- Research & Development, Ferring Pharmaceuticals A/S, Ferring International PharmaScience Center, 2770 Copenhagen, Denmark
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Bhojani N, Chew BH, Bhattacharyya S, Krambeck AE, Ghani KR, Miller LE. Effect of preoperative alpha-blockers on ureteroscopy outcomes: A meta-analysis of randomised trials. BJUI COMPASS 2024; 5:613-620. [PMID: 39022659 PMCID: PMC11249831 DOI: 10.1002/bco2.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/21/2024] [Accepted: 03/07/2024] [Indexed: 07/20/2024] Open
Abstract
Objectives This work aims to determine the efficacy and safety of preoperative alpha-blocker therapy on ureteroscopy (URS) outcomes. Methods In this systematic review and meta-analysis of randomised trials of URS with or without preoperative alpha-blocker therapy, outcomes included the need for ureteral dilatation, stone access failure, procedure time, residual stone rate, hospital stay, and complications. Residual stone rates were reported with and without adjustments for spontaneous stone passage, medication noncompliance, or adverse events leading to patient withdrawal. Data were analysed using random-effects meta-analysis and meta-regression. Certainty of evidence was assessed using the GRADE criteria. Results Among 15 randomised trials with 1653 patients, URS was effective and safe with a stone-free rate of 81.2% and rare (2.3%) serious complications. The addition of preoperative alpha-blockers reduced the need for ureteral dilatation (risk ratio [RR] = 0.48; 95% CI = 0.30 to 0.75; p = 0.002), access failure rate (RR = 0.36; 95% CI = 0.23 to 0.57; p < 0.001), procedure time (mean difference [MD] = -6 min; 95% CI = -8 to -3; p < 0.001), risk of residual stone in the primary (RR = 0.44; 95% CI = 0.33 to 0.66; p < 0.001) and adjusted (RR = 0.52; 95% CI = 0.40 to 0.68; p < 0.001) analyses, hospital stay (MD = -0.3 days; 95% CI = -0.4 to -0.1; p < 0.001), and complication rate (RR = 0.46; 95% CI = 0.35 to 0.59; p < 0.001). Alpha-blockers increased ejaculatory dysfunction risk and were less effective for renal/proximal ureter stones. The certainty of evidence was high or moderate for all outcomes. The main limitation of the review was inconsistency in residual stone assessment methods. Conclusion While URS is an effective and safe treatment for stone disease, preoperative alpha-blocker therapy is well tolerated and can further improve patient outcomes.
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Affiliation(s)
- Naeem Bhojani
- Division of UrologyCentre Hospitalier de l'Université de Montréal, MontréalQuébecCanada
| | - Ben H. Chew
- Department of Urologic SciencesUniversity of British ColumbiaVancouverBCCanada
| | - Samir Bhattacharyya
- Health Economics and Market AccessBoston ScientificMarlboroughMassachusettsUSA
| | - Amy E. Krambeck
- Department of UrologyNorthwestern University School of MedicineChicagoIllinoisUSA
| | - Khurshid R. Ghani
- Department of UrologyUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Larry E. Miller
- Department of BiostatisticsMiller ScientificJohnson CityTennesseeUSA
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Kronenberg P. Alpha-blockers: the magic pill for endourology-The great delusion. World J Urol 2024; 42:109. [PMID: 38421483 DOI: 10.1007/s00345-024-04785-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 01/10/2024] [Indexed: 03/02/2024] Open
Abstract
PURPOSE The present paper takes a different and more critical look at the role of alpha-blockers, sometimes nicknamed as "magical pills", in particular for stone disease and medical expulsive therapy (MET). METHODS A non-systematic narrative review was performed, synthesizing pertinent information from selected articles, and critically evaluating their conclusions. Sometimes different views on alpha-blockers were laid bare, including curiosities or other entertaining nuances suitable to the present topic, but always maintaining sharp objectivity and the foremost scientific rigor. RESULTS AND CONCLUSIONS Alpha-blockers seem to be a panacea, being used to treat a wide variety of non-urological diseases and conditions. Urological applications include erectile dysfunction to benign prostatic hyperplasia, from incontinence to urinary retention, or even to facilitate urinary stone passage along the urinary tract. Due to its versatility, alpha-blockers appear to be the Swiss army knife of urological medications. However, the efficacy of alpha-blockers for MET, pain management, or facilitating upper tract access is very disappointing, bringing no, or in some instances, only marginal benefits. Their treatment results are far from being significant or impressive let alone magical. Regular sexual intercourse is an effective alternative to alpha-blockers, providing faster ureteral stone expulsion rates and reducing the need for pain medication. Most of the research supporting alpha-blockers has been based on single-center, underpowered, low-quality studies. These low-quality studies biased several subsequent meta-analyses, contaminating them with their low-quality data, enhancing and prolonging this delusion. These results emphasize the need for large, multi-centric, unbiased, randomized, double-blinded, placebo-controlled trials to prevent future year-long delusions that may afflict any medical field.
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Affiliation(s)
- Peter Kronenberg
- CUF Descobertas Hospital, Member of PETRA UroGroup (Progress in Endourology, Technology and Research Association), Lisbon, Portugal.
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Pourafzali SM, Sanei A, Abdolrazaghnejad A, Poursadra E. A Comparative Study of the Effect of Intravenous Morphine and Ketorolac on Pain Control in Patients with Renal Colic. Adv Biomed Res 2023; 12:45. [PMID: 37057227 PMCID: PMC10086651 DOI: 10.4103/abr.abr_278_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 04/15/2023] Open
Abstract
Background The present study aimed at comparing the effect of ketorolac and morphine on the pain control in patients with renal colic. Materials and Methods The present clinical trial was performed on 272 patients with renal colic that were divided into two groups. Patients in the first and second groups intravenously received morphine at a dose of 1.0 mg/kg and ketorolac at a dose of 30 mg, respectively. Then, systolic blood pressure, diastolic blood pressure, heart rate, respiration rate (RR), and oxygen saturation percentage (SpO2) as well as patients' pain scores before and 5, 15, 30, 60, and 90 min after the intervention were recorded and evaluated. Results The results of this study revealed that the mean pain scores of patients before and after the intervention were not significantly different between the two groups (P > 0.05). However, patients' pain significantly relieved over time in both groups (reduce: Morphine group = 9.4 and ketorolac group = 9.09; P < 0.001). In addition, nausea, dizziness, and a decreased SpO2 in the morphine group were 5.1%, 2.9%, and 1.5%, respectively, and in the ketorolac group only dizziness was 2.2% (P > 0.05). Conclusion According to the results of this study, the efficacy of ketorolac in reducing patients' pain was not significantly different from that of morphine. Therefore, considering that the occurrence of complications in the ketorolac group was lower than that of the morphine group, it can be stated that ketorolac is a safer and more reliable drug than morphine in relieving pain in patients with renal colic.
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Affiliation(s)
- Seyed Mehdi Pourafzali
- Department of Emergency Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Abdolrahim Sanei
- Department of Emergency Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Ali Abdolrazaghnejad
- Department of Emergency Medicine, Khatam-Al-Anbia Hospital, Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Elahe Poursadra
- Community Health Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
- Address for correspondence: Prof. Elahe Poursadra, Community Health Research Center, Islamic Azad University, Isfahan Branch (Khorasgan), Isfahan, Iran. E-mail:
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Ramasamy V, Aarthy P, Sharma V, Singh Thakur A. Role of inflammatory markers and their trends in predicting the outcome of medical expulsive therapy for distal ureteric calculus. Urol Ann 2022; 14:8-14. [PMID: 35197696 PMCID: PMC8815354 DOI: 10.4103/ua.ua_139_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/30/2021] [Indexed: 11/10/2022] Open
Abstract
Objective: Symptomatic ureteric stones cause surrounding inflammation-promoting obstruction. C-reactive protein (CRP), white blood cell count (WC), and neutrophil percentage (NP) tend to rise after inflammatory response. Monitoring response during the course of medical expulsive therapy (MET) may help in deciding early intervention, thereby decreasing morbidity. We assessed the role and trends of these markers in predicting the outcome of MET. Materials and Methods: One hundred and ninety-two patients with distal ureteric calculus of size >5 mm were included in this prospective study from April 2017 to March 2018 after ethical committee approval. CRP, NP, and WC were measured on day 1, 7, and 14 of MET, and analysis was done. Results: On univariate analysis, stone size and mean values of CRP, WC, and NP on day 1, 7 and 14 in stone nonpassers were significantly higher compared to stone passers (P < 0.05). Receiver operator curve analysis showed area under the curve value of 0.798 (P = 0.001) for CRP and cut off value determined was 1.35 mg/dL. Multivariate analysis of different variables showed significant association of higher CRP (>1.35 mg/dL) and larger stone size (>7 mm) with MET failure. Decreasing trend of CRP was seen in both groups, but values were higher in stone nonpassers. WC and NP showed decreasing trend in stone passers but persistently high in stone nonpassers. Conclusions: Higher CRP and larger stone size were associated with failure of MET. WC and NP showed decreasing trend in stone passers and persistently higher in nonpassers, which may potentially predict failure of MET, however, their role need to be further studied.
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Lee JY, Andonian S, Bhojani N, Bjazevic J, Chew BH, De S, Elmansy H, Lantz-Powers AG, Pace KT, Schuler TD, Singal RK, Wang P, Ordon M. Canadian Urological Association guideline: Management of ureteral calculi - Abridged version. Can Urol Assoc J 2021; 15:383-393. [PMID: 34847343 PMCID: PMC8631858 DOI: 10.5489/cuaj.7652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jason Y. Lee
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Sero Andonian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Naeem Bhojani
- Department of Urology, Université de Montréal, Montreal, QC, Canada
| | - Jennifer Bjazevic
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Ben H. Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Shubha De
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Hazem Elmansy
- Urology, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | | | - Kenneth T. Pace
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Trevor D. Schuler
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Rajiv K. Singal
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Peter Wang
- London Health Sciences Centre, Western University, London, ON, Canada
| | - Michael Ordon
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
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Lee JY, Andonian S, Bhojani N, Bjazevic J, Chew BH, De S, Elmansy H, Lantz-Powers AG, Pace KT, Schuler TD, Singal RK, Wang P, Ordon M. Canadian Urological Association guideline: Management of ureteral calculi - Full-text. Can Urol Assoc J 2021; 15:E676-E690. [PMID: 34464257 PMCID: PMC8631842 DOI: 10.5489/cuaj.7581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jason Y. Lee
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Sero Andonian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Naeem Bhojani
- Department of Urology, Université de Montréal, Montreal, QC, Canada
| | - Jennifer Bjazevic
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Ben H. Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Shubha De
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Hazem Elmansy
- Urology, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | | | - Kenneth T. Pace
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Trevor D. Schuler
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Rajiv K. Singal
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Peter Wang
- London Health Sciences Centre, Western University, London, ON, Canada
| | - Michael Ordon
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
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Sharma G, Kaundal P, Pareek T, Tyagi S, Sharma AP, Devana SK, Singh SK. Comparison of efficacy of various drugs used for medical expulsive therapy for distal ureter stones: A systematic review and network meta-analysis. Int J Clin Pract 2021; 75:e14214. [PMID: 33825273 DOI: 10.1111/ijcp.14214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Medical expulsive therapy has been found to be effective for distal ureteric stones; however, which drug is most efficacious in terms of stone expulsion rate (SER) and stone expulsion time (SET) is not known. With this review we aimed to compare the efficacy of various drug treatments for distal ureter stones used as medical expulsive therapy in terms of SER and SET. METHODS Systematic literature search was conducted to include all the randomised study comparing various drug interventions for lower ureter stones. Standard preferred reporting items for systematic review and meta-analysis for network meta-analysis (PRISMA-NMA) were pursued. RESULTS In this review, 50 randomised studies with 12,382 patients were included. For stone expulsion rate (SER), compared with placebo all the treatment groups were more effective except nifedipine and sildenafil. According to the SUCRA values obtained, naftopidil plus steroid was the highest rank and nifedipine lowest. For stone expulsion time (SET), compared with placebo only tadalafil plus silodosin, nifedipine plus steroid, alfuzosin, silodosin, tadalafil and tamsulosin were more effective. SUCRA values were highest for tadalafil plus silodosin and least for naftopidil plus steroid. From subgroup analysis with individual drugs for SER, SUCRA values were highest for naftopidil followed by silodosin and SET was highest for silodosin and least for naftopidil. CONCLUSION For lower ureter stone, tadalafil plus silodosin is the best combination and silodosin best individual drug considering the SET and SER. Nifedipine as monotherapy is no more effective than control group.
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Affiliation(s)
- Gopal Sharma
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pawan Kaundal
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Pareek
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shantanu Tyagi
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditya P Sharma
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sudheer K Devana
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shrawan K Singh
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Almeras C, Denis E, Meria P, Estrade V, Raynal G, Hoznek A, Malval B, Dominique S, Bart S, Gautier JR, Abid N. [Recommendations of the Urolithiasis Committee of the French Urology Association for the management and the treatment of the stone formers patients during the COVID-19 pandemic crisis]. Prog Urol 2020; 30:426-429. [PMID: 32389492 PMCID: PMC7198169 DOI: 10.1016/j.purol.2020.04.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 11/23/2022]
Abstract
Confrontés à une crise d’une ampleur exceptionnelle liée à la pandémie à coronavirus COVID-19 responsable d’une saturation selon les régions des urgences et des places en réanimation, le Comité Lithiase de l’Association Française d’Urologie (CLAFU) a élaboré pour la première fois les recommandations de prise en charge des calculs urinaires durant cette crise sanitaire.
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Affiliation(s)
- C Almeras
- Urologie, Uro. Sud, RGDS Clinique La Croix du Sud, 52 bis, chemin de Ribaute, 31130 Quint Fonsegrives.
| | - E Denis
- Urologie, Centre hospitalier Saint Joseph Saint Luc, Lyon
| | - P Meria
- Urologie, Hôpital Saint Louis, Paris
| | - V Estrade
- Urologie, Centre hospitalier d'Angoulême, France
| | - G Raynal
- Urologie, Clinique médico- chirurgicale Gaston Métivet, Saint-Maur-des-Fossés
| | - A Hoznek
- Urologie, Hôpital Henri Mondor, Créteil
| | - B Malval
- Urologie, Clinique Saint Hilaire, Rouen
| | - S Dominique
- Urologie, Cabinet d'Urologie Paris Opéra, Paris
| | - S Bart
- Urologie, Centre Hospitalier René Dubos, Pontoise
| | - J R Gautier
- Urologie, Uro. Sud, RGDS Clinique La Croix du Sud, 52 bis, chemin de Ribaute, 31130 Quint Fonsegrives
| | - N Abid
- Urologie, Hospices civils de Lyon, Lyon
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Medical Expulsive Therapy for Urinary Stones: Future Trends and Knowledge Gaps. Eur Urol 2019; 76:658-666. [DOI: 10.1016/j.eururo.2019.07.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/31/2019] [Indexed: 02/06/2023]
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Erturhan S, Bayrak Ö, Şen H, Yılmaz AE, Seçkiner İ. Can alpha blockers facilitate the placement of ureteral access sheaths in retrograde intrarenal surgery? Turk J Urol 2019; 45:108-112. [PMID: 30875288 DOI: 10.5152/tud.2019.63373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/22/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the effects of alpha blocker treatment on the placement of ureteral access sheaths (UAS) during retrograde intrarenal surgery (RIRS). MATERIAL AND METHODS This study was a retrospective analysis of prospectively collected data. Patients who underwent RIRS due to renal stones between November 2015 and December 2017 were seperated into two groups. Age, gender, body mass index (BMI), stone size, laterality, hydronephrosis degree, and renal stone density were recorded. Tamsulosin (0.4 mg/day) was prescribed to the study group (n=25) 2 weeks before the operation. The control group (n=25) underwent the operation without any additional treatment. All the operations were performed using a 7.5 Fr flexible ureteroscope and 9.5/11.5 Fr (Cook, Blooming, USA) UAS. RESULTS Two patients in the study group were excluded from the study as they suffered from dizziness and retrograde ejaculation. No statistically significant difference was found between the patients in the study group (n=23) and control group (n=25) in terms of age, gender, BMI, stone size, laterality, hydronephrosis, and renal stone density (p=0.470, p=0.536, p=0.456, p=0.102, p=0.555, p=0.732, and p=0.317, respectively). The UAS could be successfully placed on the first attempt in 15 (65.2%) patients in the study group and 11 (44%) patients in the control group during the first attempt itself. Even though the successful UAS placement rate was higher in the study group, no statistically significant values were observed (p=0.141). CONCLUSION The data obtained from the present study showed that the use of alpha blockers prior to RIRS did not improve the UAS placement rates. It is considered that studies conducted on more patients might be able to achieve significant values.
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Affiliation(s)
- Sakıp Erturhan
- Department of Urology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Ömer Bayrak
- Department of Urology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Haluk Şen
- Department of Urology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Ali Erdem Yılmaz
- Department of Urology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - İlker Seçkiner
- Department of Urology, Gaziantep University School of Medicine, Gaziantep, Turkey
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Yallappa S, Amer T, Jones P, Greco F, Tailly T, Somani BK, Umez-Eronini N, Aboumarzouk OM. Natural History of Conservatively Managed Ureteral Stones: Analysis of 6600 Patients. J Endourol 2018; 32:371-379. [DOI: 10.1089/end.2017.0848] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sachin Yallappa
- Glasgow Urological Research Unit, Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
- Department of Urology, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Tarik Amer
- Glasgow Urological Research Unit, Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
- Department of Urology, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Patrick Jones
- Department of Urology, University Hospitals Southampton NHS Trust, Southampton, United Kingdom
| | - Francesco Greco
- Department of Urology, EAU Young Academic Urologists Group, Arnhem, The Netherlands
| | - Thomas Tailly
- Department of Urology, EAU Young Academic Urologists Group, Arnhem, The Netherlands
| | - Bhaskar K. Somani
- Department of Urology, University Hospitals Southampton NHS Trust, Southampton, United Kingdom
- Department of Urology, EAU Young Academic Urologists Group, Arnhem, The Netherlands
| | - Nkem Umez-Eronini
- Glasgow Urological Research Unit, Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Omar M. Aboumarzouk
- Glasgow Urological Research Unit, Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
- Department of Urology, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
- Department of Urology, EAU Young Academic Urologists Group, Arnhem, The Netherlands
- Department of Urology, Islamic Universities of Gaza, College of Medicine, Gaza, Palestine
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EL-Nahas AR. Editorial Comment on: Natural History of Conservatively Managed Ureteral Stones: Analysis of 6600 Patients by Yallappa et al.. J Endourol 2018; 32:380. [DOI: 10.1089/end.2018.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ahmed R. EL-Nahas
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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Gadelkareem RA, Shahat AA, Abdelhafez MF, Moeen AM, Ibrahim AS, Safwat AS. Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. VI. Unusual Events in Urolithiasis: 1. Long-Standing Urethral Stones without Underlying Anatomical Abnormalities in Male Children. Urol Int 2018; 101:85-90. [PMID: 29874665 DOI: 10.1159/000488398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/13/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The study aimed to present our center's experience with long-standing urethral stones in male children with normal urethra. MATERIALS AND METHODS Retrospective search of our center data was done for the cases of long-standing urethral stones with normal urethra in male children during the period July 2001 - June 2016. Demographic and clinical data were studied. RESULTS Of more than 54,000 urolithiasis procedures, 17 male children (0.031%) were operated for long-standing urethral stones with normal urethra. In 14 cases (82.4%), residence was rural and parental education levels were low or none. All children were regularly prompted voiding with a history of difficulty or dysuria. All the stones lodged in the posterior urethra with an approximate mean duration of 2 months. The mean stone size of 11.29 ± 3.88 mm and rough surfaces in 88.2% of cases represented the main predisposing factors. Major complications included rectal prolapse in 1 case and vesicoureteral reflux in 3 cases. Endoscopic push-back was followed by disintegration in 76.5% or cystolithotomy in 17.7%, while it failed in 1 case that was treated by cystolithotomy. CONCLUSIONS Long-standing urethral stones in male children with normal urethra are very rare misdiagnoses. Stone topography and sociocultural factors predisposed to their lodgments and negligence. Endoscopic treatment is the best approach.
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Affiliation(s)
- Rabea A Gadelkareem
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed A Shahat
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed F Abdelhafez
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed M Moeen
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdelrady S Ibrahim
- Department of Anesthesia and Intensive Care, Assiut University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed S Safwat
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
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