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World Journal of Urology

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01-12-2024 | Tamsulosin | Topic Paper

Alpha-blockers: the magic pill for endourology—The great delusion

Author: Peter Kronenberg

Published in: World Journal of Urology | Issue 1/2024

Abstract

Purpose

The present paper takes a different and more critical look at the role of alpha-blockers, sometimes nicknamed as “magical pills”, in particular for stone disease and medical expulsive therapy (MET).

Methods

A non-systematic narrative review was performed, synthesizing pertinent information from selected articles, and critically evaluating their conclusions. Sometimes different views on alpha-blockers were laid bare, including curiosities or other entertaining nuances suitable to the present topic, but always maintaining sharp objectivity and the foremost scientific rigor.

Results and Conclusions

Alpha-blockers seem to be a panacea, being used to treat a wide variety of non-urological diseases and conditions. Urological applications include erectile dysfunction to benign prostatic hyperplasia, from incontinence to urinary retention, or even to facilitate urinary stone passage along the urinary tract. Due to its versatility, alpha-blockers appear to be the Swiss army knife of urological medications. However, the efficacy of alpha-blockers for MET, pain management, or facilitating upper tract access is very disappointing, bringing no, or in some instances, only marginal benefits. Their treatment results are far from being significant or impressive let alone magical. Regular sexual intercourse is an effective alternative to alpha-blockers, providing faster ureteral stone expulsion rates and reducing the need for pain medication. Most of the research supporting alpha-blockers has been based on single-center, underpowered, low-quality studies. These low-quality studies biased several subsequent meta-analyses, contaminating them with their low-quality data, enhancing and prolonging this delusion. These results emphasize the need for large, multi-centric, unbiased, randomized, double-blinded, placebo-controlled trials to prevent future year-long delusions that may afflict any medical field.

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Title: Alpha-blockers: the magic pill for endourology—The great delusion
Author: Peter Kronenberg
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Tamsulosin
Endoscopy of the Urinary Tract
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04785-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Alpha-blockers: the magic pill for endourology—The great delusion

Abstract

Purpose

Methods

Results and Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results and Conclusions

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