Efficacy of α-Blockers for the Treatment of Ureteral Stones
- 1 March 2007
- journal article
- research article
- Published by Wolters Kluwer Health in Journal of Urology
- Vol. 177 (3), 983-987
- https://doi.org/10.1016/j.juro.2006.10.023
Abstract
We determined if alpha-blocker therapy promotes expulsion of ureteral stones. Meta-analysis was performed of randomized clinical trials of alpha-blockers for the treatment of ureteral stones. The primary outcome was overall stone expulsion rate. Risk ratios and risk differences were estimated using DerSimonian and Laird random effects models. Eleven trials (911 participants) met inclusion criteria for this study. Pooled analysis demonstrated significantly increased rates of stone expulsion with alpha-blocker therapy. Compared to patients receiving conservative therapy only, patients receiving conservative therapy plus alpha-blockers were 44% more likely to spontaneously expel the stones (RR 1.44, 95% CI 1.31 to 1.59, p<0.001), and stone expulsion incidence increased significantly (RD 0.28, 95% CI 0.22 to 0.34, p<0.001). Sensitivity and subgroup analyses categorized by specific alpha-blocker, prior use of shock wave lithotripsy and stone size produced similar effect estimates, but were generally less precise due to smaller sample sizes. The largest subgroup of trials (664 participants) studied tamsulosin without prior shock wave lithotripsy (RR 1.44, 95% CI 1.32 to 1.58; RD 0.29, 95% CI 0.23 to 0.35). alpha-Blocker therapy is associated with significantly increased rates of distal ureteral stone expulsion.Keywords
This publication has 18 references indexed in Scilit:
- Medical Expulsive Treatment of Distal-Ureteral Stones Using Tamsulosin: A Single-Center ExperienceJournal of Endourology, 2006
- Nonsurgical Management of Urolithiasis: An Overview of Expulsive TherapyJournal of Endourology, 2005
- RANDOMIZED TRIAL OF THE EFFICACY OF TAMSULOSIN, NIFEDIPINE AND PHLOROGLUCINOL IN MEDICAL EXPULSIVE THERAPY FOR DISTAL URETERAL CALCULIJournal of Urology, 2005
- 509: Evidence for the Presence of α1 Adrenoceptor Subtypes in the Human UreterJournal of Urology, 2005
- 1104: Doxazosin Relaxes Ureteral Smooth Muscle and Reverses Epinephrine-Induced Ureteral ContractilityJournal of Urology, 2005
- UROLOGIC DISEASES IN AMERICA PROJECT: UROLITHIASISJournal of Urology, 2005
- Does tamsulosin enhance lower ureteral stone clearance with or without shock wave lithotripsy?Urology, 2004
- NIFEDIPINE VERSUS TAMSULOSIN FOR THE MANAGEMENT OF LOWER URETERAL STONESJournal of Urology, 2004
- Efficacy of Tamsulosin in the Medical Management of Juxtavesical Ureteral StonesJournal of Urology, 2003
- Funnel plots for detecting bias in meta-analysisJournal of Clinical Epidemiology, 2001