1
|
Abdelaal MA, El-Dydamony EM. Comparative study between Tamsulosin, Silodosin and Tadalafil as a medical expulsive therapy for lower ureteral stones. Arch Ital Urol Androl 2023; 95:10849. [PMID: 36924384 DOI: 10.4081/aiua.2023.10849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/06/2022] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To compare the efficacy of Tamsulosin, Silodosin and Tadalafil as a medical expulsive therapy for treatment of distal ureteral calculi. PATIENTS AND METHODS Over a period of 6 months (January 2022 to June 2022) this prospective randomized study was conducted on 170 patients with distal ureteric stone ≤ 10 mm. Patients were randomly divided into three groups. Patients in group A received Tamsulosin 0.4mg, in group B received Silodosin, and in group C receive Tadalafil 5 mg. Therapy was given for a maximum of 4 weeks. The rate and time of stone expulsion, the analgesic use, attacks of colic and hospital visits for pain, and adverse effects of drugs were recorded. RESULTS Among 170 patients who were enrolled in study, 20 were lost to follow-up (7, 8, 5 in group A, B, And C respective-ly). There was a significant higher stone passage rate in group C than group A and B (90% vs. 70% and 76% respectively; p-value = 0.043) and shorter expulsion time in group C (8.7 ± 3.3 days) vs. group A (12.5 ± 5.2 days) and group B (11.3 ± 4.2 days) with (p-value = 0.001)(highly statistically significant with p-value < 0.001) and increased amount of analgesics required in group A (225 ± 115.7 mg) and group B (163 ± 77.5 mg) when compared with group C (120 ± 55.3 mg). CONCLUSION Tadalafil is more effective than Tamsulosin and Silodosin in treatment of patients with distal ureteric stones ≤ 10 mm as regard stone expulsion rate, expulsion time with decreased number of colicky episodes and side effects.
Collapse
|
2
|
Sun K, Zhang P, Sun Y, Wang Q, Xia Q. Meta-analysis of the efficacy and adverse drug reactions of adrenergic alpha-antagonists in treating children with ureteral calculi. Front Pediatr 2023; 11:1098002. [PMID: 36911021 PMCID: PMC9992449 DOI: 10.3389/fped.2023.1098002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
This meta-analysis investigated the efficacy and adverse drug reactions (ADRs) of three different adrenergic alpha-antagonists during the treatment of pediatric ureteral stones. Studies were retrieved from MEDLINE, EMBASE, and the Cochrane Controlled Trial Registry until January 2022. We identified 7 articles, including six RCTs and one cohort study. 610 children received either adrenergic alpha-antagonists or placebo. The results confirmed that the three different adrenergic alpha-antagonists could significantly increase the ureteral calculi expulsive rate and shorten the ureteral calculi expulsive time, regardless of the size of the stone "<5 mm" or "5-10 mm". Subgroup analysis suggested that all three adrenergic alpha-antagonists increased the ureteral calculi expulsive rate. Tamsulosin and silodosin also have the effect of shortening ureteral calculi expulsive time, while doxazosin has an insignificant effect on ureteral calculi expulsive time. Besides, tamsulosin and silodosin obviously reduced the number of pain episodes caused by ureteral calculi in children. We analyzed the treatment-emergent adverse events (TEAEs) caused by the treatment of three different adrenergic alpha-antagonists to explore their ADRs. The probability of ADRs was increased after treatment with adrenergic alpha-antagonists. Further subgroup analysis revealed the application of tamsulosin was positively correlated with ADRs in children with ureteral calculi, while the application of doxazosin and silodosin had no statistically significant effect on the probability of TEAEs. In a conclusion, this article systematically analyzed the efficacy and ADRs of three different adrenergic alpha-antagonists, and provided reference and guidance for the application of adrenergic alpha-antagonists to treat children ureteral calculi.
Collapse
Affiliation(s)
- Kai Sun
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Peizhi Zhang
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yanning Sun
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Qingliang Wang
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qinghua Xia
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China.,Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| |
Collapse
|
3
|
Liu H, Wang S, Zhu W, Lu J, Wang X, Yang W. Comparative efficacy of 22 drug interventions as medical expulsive therapy for ureteral stones: a systematic review and network meta-analysis. Urolithiasis 2019; 48:447-457. [DOI: 10.1007/s00240-019-01159-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 09/02/2019] [Indexed: 12/01/2022]
|
4
|
Taguchi K, Cho SY, Ng AC, Usawachintachit M, Tan YK, Deng YL, Shen CH, Gyawali P, Alenezi H, Basiri A, Bou S, Djojodemedjo T, Sarica K, Shi L, Singam P, Singh SK, Yasui T. The Urological Association of Asia clinical guideline for urinary stone disease. Int J Urol 2019; 26:688-709. [PMID: 31016804 DOI: 10.1111/iju.13957] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/04/2019] [Indexed: 12/12/2022]
Abstract
The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline - consisting 43 clinical questions - and overview its key practical issues.
Collapse
Affiliation(s)
- Kazumi Taguchi
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sung Yong Cho
- Department of Urology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.,Seoul National University Hospital, Seoul, Korea
| | - Anthony Cf Ng
- SH Ho Urology Center, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Manint Usawachintachit
- Division of Urology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Yung-Khan Tan
- Urohealth Medical Clinic, Mt Elizabeth Hospital, Singapore
| | - Yao Liang Deng
- Department of Urology, Langdong Hospital and The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Cheng-Huang Shen
- Department of Urology, Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Prem Gyawali
- Department of Urology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | - Abbas Basiri
- Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sopheap Bou
- Department of Urology, Royal Phnom Penh Hospital, Phnom Penh, Cambodia
| | - Tarmono Djojodemedjo
- Department of Urology, Soetomo General Academia Hospital/Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Kemal Sarica
- Department of Urology, Kafkas University Medical School, Kars, Turkey
| | - Lei Shi
- Department of Urology, Yantai Yuhuangding Hospital and Medical School, Qingdao University, Yantai, China
| | | | - Shrawan Kumar Singh
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| |
Collapse
|
5
|
MnO2 nanosheets as the biomimetic oxidase for rapid and sensitive oxalate detection combining with bionic E-eye. Biosens Bioelectron 2019; 130:254-261. [DOI: 10.1016/j.bios.2019.01.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/09/2018] [Accepted: 01/07/2019] [Indexed: 11/21/2022]
|
6
|
What Is the Role of α-Blockers for Medical Expulsive Therapy? Results From a Meta-analysis of 60 Randomized Trials and Over 9500 Patients. Urology 2018; 119:5-16. [DOI: 10.1016/j.urology.2018.03.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/16/2018] [Accepted: 03/22/2018] [Indexed: 11/19/2022]
|
7
|
Ye Z, Zeng G, Yang H, Tang K, Zhang X, Li H, Li W, Wu Z, Chen L, Chen X, Liu X, Deng Y, Pan T, Xing J, Wang S, Cheng Y, Gu X, Gao W, Yang J, Zhang Y, Mi Q, Qi L, Li J, Hu W, Liang P, Sun Z, Xu C, Long Y, Liao Y, Liu S, Liu G, Xu X, He W, Chen Z, Xu H. Efficacy and Safety of Tamsulosin in Medical Expulsive Therapy for Distal Ureteral Stones with Renal Colic: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial. Eur Urol 2017; 73:385-391. [PMID: 29137830 DOI: 10.1016/j.eururo.2017.10.033] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/26/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recent large high-quality trials have questioned the clinical effectiveness of medical expulsive therapy using tamsulosin for ureteral stones. OBJECTIVE To evaluate the efficacy and safety of tamsulosin for distal ureteral stones compared with placebo. DESIGN, SETTING, AND PARTICIPANTS We conducted a double-blind, placebo-controlled study of 3296 patients with distal ureteral stones, across 30 centers, to evaluate the efficacy and safety of tamsulosin. INTERVENTION Participants were randomly assigned (1:1) into tamsulosin (0.4mg) or placebo groups for 4 wk. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary end point of analysis was the overall stone expulsion rate, defined as stone expulsion, confirmed by negative findings on computed tomography, over a 28-d surveillance period. Secondary end points included time to stone expulsion, use of analgesics, and incidence of adverse events. RESULTS AND LIMITATIONS Among 3450 patients randomized between September 1, 2011, and August 31, 2013, 3296 (96%) were included in the primary analysis. Tamsulosin benefits from a higher stone expulsion rate than the placebo (86% vs 79%; p<0.001) for distal ureteral stones. Subgroup analysis identified a specific benefit of tamsulosin for the treatment of large distal ureteral stones (>5mm). Considering the secondary end points, tamsulosin-treated patients reported a shorter time to expulsion (p<0.001), required lower use of analgesics compared with placebo (p<0.001), and significantly relieved renal colic (p<0.001). No differences in the incidence of adverse events were identified between the two groups. CONCLUSIONS Our data suggest that tamsulosin use benefits distal ureteral stones in facilitating stone passage and relieving renal colic. Subgroup analyses find that tamsulosin provides a superior expulsion rate for stones >5mm, but no effect for stones ≤5mm. PATIENT SUMMARY In this report, we looked at the efficacy and safety of tamsulosin for the treatment of distal ureteral stones. We find that tamsulosin significantly facilitates the passage of distal ureteral stones and relieves renal colic.
Collapse
Affiliation(s)
- Zhangqun Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Institute of Urology, Wuhan, China
| | - Guohua Zeng
- The Center of Minimally-invasive Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huan Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Institute of Urology, Wuhan, China
| | - Kun Tang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Institute of Urology, Wuhan, China
| | - Xiaochun Zhang
- The Institute of Urology, Peking University, Beijing, China
| | - Hong Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Weibing Li
- Department of Urology and Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhong Wu
- Department of Urology, Huashan Hospital of Fudan University, Shanghai, China
| | - Lingwu Chen
- Department of Urology, the First Affiliated Hospital of Zhongshan University, Guangzhou, China
| | - Xingfa Chen
- Department of Urology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiankui Liu
- Department of Urology, the First Affiliated Hospital of Chinese Medical University, Shenyang, China
| | - Yaoliang Deng
- Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Tiejun Pan
- Department of Urology, Wuhan General Hospital of Guangzhou Military Region, Wuhan, China
| | - Jinchun Xing
- Department of Urology, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Shusheng Wang
- Department of Urology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yue Cheng
- Department of Urology, the First People's Hospital of Ningbo City, Ningbo University Medical School, Ningbo, China
| | - Xiaojian Gu
- Department of Urology, JiangSu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Wenxi Gao
- Department of Urology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Jianggen Yang
- Department of Urology, the People's Hospital of Shenzhen, Shenzhen, China
| | - Yonghai Zhang
- Department of Urology, Shantou Central Hospital, Shantou, China
| | - Qiwu Mi
- Department of Urology, the People's Hospital of Dongguan, Dongguan, China
| | - Lin Qi
- Department of Urology, Xiangya Hospital of Centra South University, Changsha, China
| | - Jiongming Li
- Department of Urology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Weilie Hu
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, China
| | - Peiyu Liang
- Department of Urology, the Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Zhaolin Sun
- Department of Urology, the People's Hospital of Guizhou Province, Guiyang, China
| | - Changbao Xu
- Department of Urology, the Second Affiliated Hospital of Zhengzhou University Medical School, Zhengzhou, China
| | - Yongfu Long
- Department of Urology, Shaoyang Central Hospital, Shaoyang, China
| | - Yongbin Liao
- Department of Urology, Jiangmen Hospital of Zhongshan University, Jiangmen, China
| | - Siping Liu
- Department of Urology, Meizhou Hospital of Zhongshan University, Meizhou, China
| | - Guoqing Liu
- Department of Urology, Foshan Maternal and Child Health Care Hospital of Nanfang Medical University, Foshan, China
| | - Xun Xu
- Department of Urology, Nanhai Hospital of Nanfang Medical University
| | - Wei He
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Institute of Urology, Wuhan, China
| | - Zhiqiang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Institute of Urology, Wuhan, China.
| | - Hua Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Institute of Urology, Wuhan, China.
| |
Collapse
|
8
|
Amer T, Osman B, Johnstone A, Mariappan M, Gupta A, Brattis N, Jones G, Somani BK, Keeley FX, Aboumarzouk OM. Medical expulsive therapy for ureteric stones: Analysing the evidence from systematic reviews and meta-analysis of powered double-blinded randomised controlled trials. Arab J Urol 2017; 15:83-93. [PMID: 29071136 PMCID: PMC5653615 DOI: 10.1016/j.aju.2017.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 03/23/2017] [Accepted: 03/27/2017] [Indexed: 11/09/2022] Open
Abstract
Objective To conduct a systematic review and meta-analysis investigating the efficacy and safety of medical expulsive therapy (MET) in low risk of bias (RoB) randomised controlled trials (RCTs). Methods A Cochrane style systematic review was conducted on published literature from 1990 to 2016, to include low RoB and a power calculation. A pooled meta-analysis was conducted. Results The MET group included 1387 vs 1381 patients in the control group. The analysis reveals α-blockers increased stone expulsion rates (78% vs 74%) (P < 0.001), whilst calcium channel blockers (CCBs) had no effect compared to controls (79% vs 75%) (P = 0.38). In the subgroup analysis, α-blockers had a shorter time to stone expulsion vs the control group (P < 0.001). There were no significant differences in expulsion rates between the treatment groups and control group for stones <5 mm in size (P = 0.48), proximal or mid-ureteric stones (P = 0.63 and P = 0.22, respectively). However, α-blockers increased stone expulsion in stones >5 mm (P = 0.02), as well as distal ureteric stones (P < 0.001). The α-blocker group developed more side-effects (6.6% of patients; P < 0.001). The numbers needed to treat for α-blockers was one in 14, for stones >5 mm one in eight, and for distal stones one in 10. Conclusion The primary findings show a small overall benefit for α-blockers as MET for ureteric stones but no benefit with CCBs. α-blockers show a greater benefit for large (>5 mm) ureteric stones and those located in the distal ureter, but no benefit for smaller or more proximal stones. α-blockers are associated with a greater risk of side-effects compared to placebo or CCBs.
Collapse
Affiliation(s)
| | - Banan Osman
- Bristol Urological Institutes, North Bristol NHS Trust, Bristol, UK
| | | | | | | | - Nikolaos Brattis
- Bristol Urological Institutes, North Bristol NHS Trust, Bristol, UK
| | | | | | - Francis X Keeley
- Bristol Urological Institutes, North Bristol NHS Trust, Bristol, UK
| | - Omar M Aboumarzouk
- Glasgow Royal Infirmary, Glasgow, UK.,Bristol Urological Institutes, North Bristol NHS Trust, Bristol, UK.,Queen Elizabeth University Hospitals, Glasgow, UK.,Islamic Universities of Gaza, College of Medicine, Gaza, Palestine
| |
Collapse
|
9
|
Simon JC, Maxwell AD, Bailey MR. Some Work on the Diagnosis and Management of Kidney Stones with Ultrasound. ACOUSTICS TODAY 2017; 13:52-59. [PMID: 30271311 PMCID: PMC6162072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ultrasound is currently the only noninvasive technology able to completely diagnose and manage kidney stones.
Collapse
Affiliation(s)
- Julianna C Simon
- Graduate Program in Acoustics, Pennsylvania State University, 201E Applied Science Building, University Park, Pennsylvania 16802, USA
| | - Adam D Maxwell
- Center for Industrial and Medical, Ultrasound, Applied Physics Laboratory and Department of Urology, University of Washington, 1013 NE 40th Street, Seattle, Washington 98105, USA
| | - Michael R Bailey
- Center for Industrial and Medical, Ultrasound, Applied Physics Laboratory;, Department of Mechanical Engineering; and Department of Urology, University of Washington, 1013 NE 40th Street, Seattle, Washington 98105, USA
| |
Collapse
|