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Alpha-blockers have been established as medical expulsive therapy for urolithiasis. We aimed to assess the effect of tamsulosin and doxazosin as adjunctive therapy following SWL for renal calculi. We prospectively included 150 patients who underwent up to four SWL sessions for renal stones from June 2008 to 2009. Patients were randomized into three groups of 50 patients each, group A (phloroglucinol 240 mg daily), group B (tamsulosin 0.4 mg once daily plus phloroglucinol), and group C (doxazosin 4 mg plus phloroglucinol). The treatment continued up to maximum 12 weeks. Patients were evaluated for stone expulsion, colic attacks, amount of analgesics and side-effects of alpha-blockers. There were no significant differences between the groups regarding stone expulsion rates (84; 92 and 90%, respectively). The mean expulsion time of tamsulosin was significantly shorter than both control group (p = 0.002) and doxazosin (p = 0.026). Both number of colic episodes and analgesic dosage were significantly lower with tamsulosin as compared to control and doxazosin. Steinstrasse was encountered in 10 (6.7%) patients with no significant difference between the groups. 16 patients on tamsulosin and 21 on doxazosin experienced adverse effects related to postural hypotension. Moreover, 2 (4%) patients in the tamsulosin group reported ejaculatory complaints. In conclusion, adjunction of tamsulosin or doxazosin after SWL for renal calculi decreases the time for stone expulsion, amount of the analgesics and number colic episodes. There was no benefit regarding the overall stone expulsion rate. The side-effects of these agents are common and should be weighted against the benefits of their usage.
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
This article was published in the following journal.
Name: Urological research
A Trade Off Between Invasiveness and Efficacy: Ureteroscopy vs Shock Wave Lithotripsy: Commentary on: Comparative Effectiveness of Shock Wave Lithotripsy and Ureteroscopy for Treating Patients With Kidney Stones.
To compare outcomes of retrograde intrarenal surgery (RIRS) with extracorporeal shock wave lithotripsy (ESWL) as treatment of choice.
To evaluate the role of multidetector computed tomography (MDCT) in recognizing the complications of extracorporeal shock wave lithotripsy (ESWL) and providing a prognostic grading system for the ther...
The objective was to determine the predicting success of shock wave lithotripsy (SWL) using a combination of computed tomography based metric parameters to improve the treatment plan.
Target-controlled infusion of remifentanil with or without flurbiprofen axetil in sedation for extracorporeal shock wave lithotripsy of pancreatic stones: a prospective, open-label, randomized controlled trial.
Extracorporeal shock wave lithotripsy (ESWL) is an effective therapeutic method used to treat patients with pancreatic stones. However, the anesthesia for this procedure has been underappreciated, wit...
The purpose of this study is to determine if there is a role of prophylactic therapy with tamsulosin prior extracorporeal shock wave lithotripsy to avoid development of steinstrasse. 150 p...
The purpose of this study is to see if avanafil causes any changes in blood pressure and pulse rate when taken with doxazosin or tamsulosin.
Endoscopy is an established method of treatment for painful obstructive calcified pancreatitis. It involves the disintegration of calcifications using extracorporeal shock wave lithotripsy...
The majority of kidney stones are treated with shock wave lithotripsy (SWL). We are examining if the medication Flomax will result in improved stone passage rates following SWL.
Shockwave lithotripsy (SWL) is a safe, non-invasive treatment for renal calculi. During SWL energy is focused on in order to break kidney stones and this energy can be varied in size from ...
The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is LITHOTRIPSY, LASER.
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Nephrology - kidney function
Nephrology is a specialty of medicine and pediatrics that concerns itself with the study of normal kidney function, kidney problems, the treatment of kidney problems and renal replacement therapy (dialysis and kidney transplantation). Systemic conditions...