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Original Paper

Treatment of Ureteral Lithiasis with Tamsulosin: Literature Review and Meta-Analysis

Arrabal-Martin M. · Valle-Diaz de la Guardia F. · Arrabal-Polo M.A. · Palao-Yago F. · Mijan-Ortiz J.L. · Zuluaga-Gomez A.

Author affiliations

Department of Urology, San Cecilio University Hospital, Granada, Spain

Related Articles for ""

Urol Int 2010;84:254–259

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 07, 2009
Accepted: June 11, 2009
Published online: April 13, 2010
Issue release date: April 2010

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: http://www.karger.com/UIN

Abstract

Objective: Ninety percent of ureteral calculi <4 mm are expelled over a period of 3 months; if they are >6 mm the elimination possibilities are reduced to 30%. Presently, investigations in the treatment of ureteral lithiasis have the objective of modifying ureter contractibility with the aid of calcium antagonist and α-blocking drugs. The objective of this study is to analyze the effect of tamsulosin in the treatment of the distal ureter lithiasis and to make a systematic analysis of the literature. Patients and Methods: In a prospective study 70 cases of distal ureter lithiasis were divided into 2 groups: group 1 = 35 cases treated with ibuprofen (600 mg/12 h) and 2,000 ml water/24 h with tramadol on demand, and group 2 = 35 cases with the same treatment as described before plus tamsulosin 0.4 mg/day over 3 weeks. The number of stone-free patients, time to expulsion and the necessity for analgesia were evaluated. A literature review (2002–2007) and meta-analysis of 11 studies was performed. Statistical analysis included relative risk (RR), number needed to treat (NNT) and χ2 test. Results: Group 1 reported 19 stone expulsions (54.3%) and group 2 30 expulsions [85.7%, χ2 = 8.23 (p < 0.01), RR = 1.58, NNT = 3 (95% CI 2–9)]. The mean time to expulsion was 14 days in group 1 and 8 days in group 2. No side effects were detected. Meta-analysis included 792 patients: 392 patients in group 1 and 400 patients in group 2. Group 1 reported 211 stone expulsions (53.8%) and group 2 reported 332 expulsions [83%, χ2 = 78.17 (p < 0.01), RR = 1.54, absolute benefit = 29.2% (95% CI 23–35.3%), NNT = 3 (95% CI 3–4)]. The mean time to expulsion was 9.45 days in group 1 and 6.07 days in group 2 treated with tamsulosin; a significant difference was observed in all studies. Conclusions: Tamsulosin increases the elimination of distal ureter lithiasis of <10 mm.

© 2010 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 07, 2009
Accepted: June 11, 2009
Published online: April 13, 2010
Issue release date: April 2010

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: http://www.karger.com/UIN


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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