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Medical Expulsive Therapy of Single Distal Ureteral Stones

2014-08-27 03:24:46 | BioPortfolio

Summary

Current therapeutic options for ureteral stones include active intervention as well as conservative "watch and wait" approaches. Endoscopic treatment of ureteral stones has a high success rate and reliably results in immediate stone removal However, surgical as well as anaesthetic risks are not negligible and serious complications are possible. For many patients, a conservative treatment is an appealing option. Watchful waiting, however, not always results in stone clearance and may be associated with recurrent renal colics.

The therapeutic potential of alpha-blockers for ureteral stone disease has been investigated prompted by the detection of alpha-receptors in ureteral smooth muscle cells. Blocking of such receptors, which are predominantly located in the distal part of the ureter results in relaxation of the ureteral wall and modulation of peristaltic activity. This mechanism has been proposed to facilitate stone passage for ureteral calculi.

Numerous clinical trials have revealed a significant improvement of the stone expulsion rate using the alpha-blocker tamsulosin. Most of these studies were randomised but none were performed in a double-blind and placebo-controlled fashion. Therefore, the objective of this trial was to evaluate the efficacy of medical expulsive therapy with tamsulosin in a randomised, double-blind, placebo-controlled setting.

Study Design

Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Conditions

Ureteral Calculi

Intervention

Tamsulosin, Placebo

Location

Department of Urology, University Hospital Zürich, Switzerland
Zurich
Switzerland
8091

Status

Completed

Source

University of Zurich

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:24:46-0400

Clinical Trials [155 Associated Clinical Trials listed on BioPortfolio]

The Efficacy of Tamsulosin in the Treatment of Ureteral Stones in Emergency Department Patients

The purpose of this study is to determine the efficacy of the α-adrenergic antagonist tamsulosin in the treatment of adult emergency department (ED) patients with ureteral colic secondary...

The Efficacy of Tamsulosin in the Treatment of Ureteral Stones in Emergency Department Patients

To determine if emergency department patients with acute ureteral colic pain due to a ureteral stone who are treated with tamsulosin, versus placebo, will experience a shorter time to pass...

Evaluation of Tamsulosin in the Treatment of Ureteral Stones

Ureteral stones have an important place in daily urological practice, usually causing acute episodes of ureteral colic by obstructing the urinary tract. The aim of the study is to evaluate...

ESWL vs URS in Management of Upper Third Ureteric Calculi

comparative study of two treatment modalities (ureteroscopy and extracorporeal shock wave lithotripsy) in management of upper third ureteral calculi

The Predictive Value of Ureteral Jet Assessment With Ultrasound in Patients Presenting With Acute Renal Colic

This is a single institution, prospective study to evaluate the prognostic significance of renal and bladder ultrasound with ureteral jet assessment and its utility to evaluate the spontan...

PubMed Articles [1029 Associated PubMed Articles listed on BioPortfolio]

Simultaneous Bilateral Ureteral Calculi: A New Paradigm for Management.

To define the need for emergent intervention between patients with SBUC compared to unilateral ureteral calculi (UUC). Patients with simultaneous bilateral ureteral calculi (SBUC) represent a potentia...

Silodosin versus tamsulosin for medical expulsive treatment of ureteral stones: A systematic review and meta-analysis.

Silodosin, a recently introduced selective α-blocker, has a much higher selectivity for the α-1A receptor. The efficacy and safety of silodosin compared to tamsulosin in medical expulsive therapy (M...

Development and validation of a risk-prediction nomogram for patients with ureteral calculi associated with urosepsis: A retrospective analysis.

To develop and validate an individualized nomogram to predict probability of patients with ureteral calculi developing into urosepsis.

Comparative Study between Silodosin and Tamsulosin in Expectant Therapy of Distal Ureteral Stones.

To compare the efficacy and safety of silodosin against tamsulosin as medical expulsion therapeutic agent in stone lower 1/3rd ureter.

Effect of Tamsulosin on Passage of Symptomatic Ureteral Stones: A Randomized Clinical Trial.

Urinary stone disease is a common presentation in the emergency department, and α-adrenergic receptor blockers, such as tamsulosin, are commonly used to facilitate stone passage.

Medical and Biotech [MESH] Definitions

Stones in the URETER that are formed in the KIDNEY. They are rarely more than 5 mm in diameter for larger renal stones cannot enter ureters. They are often lodged at the ureteral narrowing and can cause excruciating renal colic.

Renal calculi with a characteristic shape like antlers of a deer, formed as it extends into multiple calices of the RENAL PELVIS. A large number of staghorn calculi as well as other URINARY CALCULI are composed of STRUVITE.

The insertion of a catheter through the skin and body wall into the kidney pelvis, mainly to provide urine drainage where the ureter is not functional. It is used also to remove or dissolve renal calculi and to diagnose ureteral obstruction.

Presence of small calculi in the terminal salivary ducts (salivary sand), or stones (larger calculi) found in the larger ducts.

Absence of urine formation. It is usually associated with complete bilateral ureteral (URETER) obstruction, complete lower urinary tract obstruction, or unilateral ureteral obstruction when a solitary kidney is present.

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