Adjunctive Medical Therapy with α-blocker After Extracorporeal Shock Wave Lithotripsy of Renal and Ureteral Stones: a Meta-analysis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Apr 11

PMID 25860144

Citations 6

Authors

Mingchao Li

Zhengyun Wang

Jun Yang

Xiaolin Guo

Tao Wang

Shaogang Wang

Chunping Yin

Jihong Liu

Zhangqun Ye

Affiliations

Soon will be listed here.

Abstract

Background: Although some trials assessed the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after extracorporeal shock wave lithotripsy (ESWL), the role of the α-blocker in facilitating upper urinary calculi expulsion after ESWL remain controversial.

Aims: To determine the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after ESWL.

Methods: A literature search was carried out using the PubMed database, EMBASE and the Cochrane Library database to identify relevant studies. Two reviewers independently extracted data and assessed methodological quality. Pooled effect estimates were obtained using a fixed- and random-effects meta-analysis.

Results: The meta-analysis included 23 RCTs, α-blocker significantly enhanced expulsion rate of upper urinary tract calculi after ESWL (P<0.00001; RR 1.21; 95% CI 1.12-1.31), significantly promoted steinstrasse expulsion (P=0.03; RR 1.25; 95% CI 1.03-1.53), significantly shortened the discharge time of upper urinary tract calculi (P=0.0001; MD -2.12; 95% CI -3.20--1.04), significantly reduced the patient's pain VAS score (P=0.001; RR -1.0; 95% CI -1.61--0.39). Compared with the control group, dizziness (P=0.002; RR 5.48; 95% CI 1.91-15.77), anejaculation (P=0.02; RR 12.17; 95% CI 1.61-91.99) and headache (P=0.04; RR 4.03; 95% CI 1.04-15.72) in the α-blocker group was associated with a higher incidence.

Conclusions: Treatment with α-blocker after ESWL appears to be effective in enhancing expulsion rate of upper urinary tract calculi, shortening the discharge time of upper urinary tract calculi, reducing the patient's pain. The side effects of α-blocker were light and few.

Citing Articles

Canadian Urological Association guideline: Management of ureteral calculi - Abridged version.

Lee J, Andonian S, Bhojani N, Bjazevic J, Chew B, De S Can Urol Assoc J. 2021; 15(12):383-393.

PMID: 34847343 PMC: 8631858. DOI: 10.5489/cuaj.7652.

Canadian Urological Association guideline: Management of ureteral calculi - Full-text.

Lee J, Andonian S, Bhojani N, Bjazevic J, Chew B, De S Can Urol Assoc J. 2021; 15(12):E676-E690.

PMID: 34464257 PMC: 8631842. DOI: 10.5489/cuaj.7581.

Alpha-blockers after shock wave lithotripsy for renal or ureteral stones in adults.

Oestreich M, Vernooij R, Sathianathen N, Hwang E, Kuntz G, Koziarz A Cochrane Database Syst Rev. 2020; 11:CD013393.

PMID: 33179245 PMC: 8092672. DOI: 10.1002/14651858.CD013393.pub2.

Adjunctive medical expulsive therapy with tamsulosin for repeated extracorporeal shock wave lithotripsy: a systematic review and meta-analysis.

Ouyang W, Sun G, Long G, Liu M, Xu H, Chen Z Int Braz J Urol. 2020; 47(1):23-35.

PMID: 32459454 PMC: 7712709. DOI: 10.1590/S1677-5538.IBJU.2020.0093.

Efficacy of Eutectic Mixture of Local Anesthetics on Pain Control During Extracorporeal Shock Wave Lithotripsy: A Systematic Review and Meta-Analysis.

Huang Y, Chai S, Wang D, Li W, Zhang X Med Sci Monit. 2020; 26:e921063.

PMID: 32400392 PMC: 7245063. DOI: 10.12659/MSM.921063.

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