Skip to main content
SpringerLink
Log in

Do alpha-1 antagonist medications affect the success of semi-rigid ureteroscopy? A prospective, randomised, single-blind, multicentric study

  • Original Paper
  • Published:
Urolithiasis Aims and scope Submit manuscript

Abstract

The objective of this study is to assess the efficacy of adjunctive silodosin therapy in improving the success rate of semi-rigid ureteroscopy for removing ureteral stones. Prospective randomised controlled clinical trial performed between July 2016 and September 2016. All the patients underwent ureteroscopic holmium lithotripsy with a YAG laser. The patients were randomised into one of three groups: those who did not use an alpha-1 blocker (AB) (Group 1, n = 50), those who used an AB for one day (Group 2, n = 50), and those who used an AB for three days (Group 3, n = 47). The following information was recorded for each patient: the side, location, and surface area of the stone; successful access; operative success; complications; and operative time. There were no significant differences between the three groups in terms of demographics, stone location or size, and number of doses of an analgesic drug used. Access to the stone and the stone-free rate were significantly higher in group 3 (95.7, 93.6%) than in group 1 (76, 74%) and group 2 (78, 74%) (p = 0.018, p = 0.021), respectively. Balloon dilatation and complication rates were significantly lower in group 3 (12.8, 0%) than in group 1 (34, 12%) and group 2 (22, 4%) (p = 0.045, p = 0.029), respectively. The use of silodosin for 3 days before ureteroscopy for ureteral stones increased the rate of access to all ureter stones and decreased the complication rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Trinchieri A, Curhan G, Karlsen S, Jun Wu K (2003) Epidemiology, in Proceedings of 1st International Consultation On Stone Disease, edited by Segura J, Conort P, Khoury S, Paris, France, Editions 21

  2. Ketabchi AA, Aziziolahi GA (2008) Prevalence of symptomatic urinary calculi in Kerman, Iran. Urol J 5:156–160

    PubMed  Google Scholar 

  3. Papadoukakis S, Stolzenburg J, Truss MC (2006) Treatment strategies of ureteral stones. Eau-Ebu Update Series, pp 4184–4190

  4. Coll DM, Varanelli MJ, Smith RC (2002) Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT. AJR Am J Roentgenol 178:101–103

    Article  PubMed  Google Scholar 

  5. Campschroer T, Zhu Y, Duijvesz D, Grobbee DE, Lock MT (2014) Alpha-blockers as medical expulsive therapy for ureteral stones. Cochrane Database Syst Rev 2:CD008509

    Google Scholar 

  6. Schuler TD, Shahani R, Honey RJ, Pace KT (2009) Medical expulsive therapy as an adjunct to improve shockwave lithotripsy outcomes: a systematic review and meta-analysis. J Endourol 23:387–393

    Article  PubMed  Google Scholar 

  7. John TT, Razdan S (2010) Adjunctive tamsulosin improves stone free rate after ureteroscopic lithotripsy of large renal and ureteric calculi: a prospective randomized study. Urology 75:1040–1042

    Article  PubMed  Google Scholar 

  8. Sigala S, Dellabella M, Milanese G, Fornari S, Faccoli S, Palazzolo F, Peroni A, Mirabella G, Cunico SC, Spano P, Muzzonigro G (2005) Evidence for the presence of alpha1 adrenoceptor subtypes in the human ureter. NeurourolUrodyn 24:142–148

    CAS  Google Scholar 

  9. Dellabella M, Milanese G, Muzzonigro G (2005) Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. J Urol 174:167–172

    Article  CAS  PubMed  Google Scholar 

  10. Huang W, Xue P, Zong H, Zhang Y (2016) Efficacy and safety of silodosin in the medical expulsion therapy for distal ureteral calculi: a systematic review and meta-analysis. Br J ClinPharmacol 81:13–22

    CAS  Google Scholar 

  11. Dupont WD, Plummer WD (1990) Power and sample size calculations: a review and computer program. Control Clin Trials 11:116–128

    Article  CAS  PubMed  Google Scholar 

  12. Dupont WD, Plummer WD (1998) Power and sample size calculations for studies involving linear regression. Control Clin Trials 19:589–601

    Article  CAS  PubMed  Google Scholar 

  13. Türk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M, Seitz C (2016) EAU Guidelines on urolithiasis. https://uroweb.org/guideline/urolithiasis

  14. Hong YK, Park DS (2009) Ureteroscopic lithotripsy using Swiss Lithoclast for treatment of ureteral calculi: 12-years experience. J Korean Med Sci 24:690–694

    Article  PubMed  PubMed Central  Google Scholar 

  15. Cui X, Ji F, Yan H, Ou TW, Jia CS, He XZ, Gao W, Wang Q, Cui B, Wu JT (2015) Comparison between extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy for treating large proximal ureteral stones: a meta-analysis. Urology 85:748–756

    Article  PubMed  Google Scholar 

  16. Malin JM Jr, Deane RF, Boyarsky S. . Urol (1970) Characterisation of adrenergic receptors in the human ureter. Br J 42:171–174

    Google Scholar 

  17. Park HK, Choi EY, Jeong BC, Kim HH, Kim BK (2007) Localizations and expressions of alpha-1A, alpha-1B and alpha-1D adrenoceptors in human ureter. Urol Res 35:325–329

    Article  CAS  PubMed  Google Scholar 

  18. Itoh Y, Okada A, Yasui T, Hamamoto S, Hirose M, Kojima Y, Tozawa K, Sasaki S, Kohri K (2011) Efficacy of selective α1A adrenoceptor antagonist silodosin in the medical expulsive therapy for ureteral stones. Int J Urol 18:672–674

    CAS  PubMed  Google Scholar 

  19. Seitz C, Liatsikos E, Porpiglia F, Tiselius HG, Zwergel U(2009) Medical therapy to facilitate the passage of stones: what is the evidence? EurUrol.56:455–471

  20. Ahmed AF, Maarouf A, Shalaby E, Alshahrani S, El-Feky M, Khaled S, Daoud A, Soliman A, Desoky E, El-Helaly H(2016) Semi-rigid ureteroscopy for proximal ureteral stones: does adjunctive tamsulosin therapy increase the chance of success? Urol Int. https://doi.org/10.1159/000452926

    Article  PubMed  Google Scholar 

  21. Bagbanci S, Dadali M, Dadalı Y, Emir L, Gorgulu O, Karabulut A (2016) Does a retropulsion prevention device equalize the surgical success of Ho:YAG laser and pneumatic lithotripters for upper ureteral stones? A prospective randomized study. Urolithiasis. https://doi.org/10.1007/s00240-016-0930-5

    Article  PubMed  Google Scholar 

  22. Chen S, Zhou L, Wei T, Luo D, Jin T, Li H, Wang K (2016) Comparison of holmium: YAG laser and pneumatic lithotripsy in the treatment of ureteral stones: an update meta-analysis. Urol Int. https://doi.org/10.1159/000448692

    Article  PubMed  Google Scholar 

  23. Ketabchi AA, Mehrabi S (2014) The effect of tamsulosin, an alpha-1 receptor antagonist as a medical expelling agent in success rate of ureteroscopic lithotripsy. Nephrourol Mon 6(1):e12836

    PubMed  Google Scholar 

  24. Yamada S, Kato Y, Okura T, Kagawa Y, Kawabe K (2007) Prediction of alpha1-adrenoceptor occupancy in the human prostate from plasma concentrations of silodosin, tamsulosin and terazosin to treat urinary obstruction in benign prostatic hyperplasia. Biol Pharm Bull 30:1237–1241

    Article  CAS  PubMed  Google Scholar 

  25. de la Rosette J, Denstedt J, Geavlete P, CROES URS Study Group (2014) The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11,885 patients. J Endourol. 28:131–139

    Article  PubMed  Google Scholar 

  26. Lai C-L, Kuo RNien-Chen, Chen H-M, Chen M-F, Chan KA, Mei-Shu Lai(2015) Risk of hip/femur fractures during the initiation period of α-adrenoceptor blocker therapy among elderly males: a self-controlled case series study. Br J ClinPharmacol 80:1208–1218

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Samsun Training and Research Hospital, University of Health Sciences, Samsun, Turkey

    Mustafa Aydın

  2. Department of Urology, Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey

    Muhammet Fatih Kılınç

  3. Department of Urology, Hatay State Hospital, Hatay, Turkey

    Abdulmecit Yavuz

  4. Department of Urology, İdil State Hospital, Şırnak, Turkey

    Göksel Bayar

Authors
  1. Mustafa Aydın
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Muhammet Fatih Kılınç
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdulmecit Yavuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Göksel Bayar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mustafa Aydın.

Ethics declarations

Conflict of interest

No conflict of interest was declared by the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aydın, M., Kılınç, M.F., Yavuz, A. et al. Do alpha-1 antagonist medications affect the success of semi-rigid ureteroscopy? A prospective, randomised, single-blind, multicentric study. Urolithiasis 46, 567–572 (2018). https://doi.org/10.1007/s00240-017-1026-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-017-1026-6

Keywords

Search

Navigation