Treatment of Ureteral Lithiasis with Tamsulosin: Literature Review and Meta-AnalysisArrabal-Martin M. · Valle-Diaz de la Guardia F. · Arrabal-Polo M.A. · Palao-Yago F. · Mijan-Ortiz J.L. · Zuluaga-Gomez A.
Department of Urology, San Cecilio University Hospital, Granada, Spain
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
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
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
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.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.