Stone Disease - Randomized Clinic Trials Suggest Lack Of Benefit To Alpha Blocker Therapy For Ureteral Calculi

Main Category: Urology / Nephrology
Article Date: 06 Jul 2008 - 0:00 PDT

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ORLANDO, FL (UroToday.com) - (Reported from the Annual Meeting of the American Urological Association) There were several randomized clinic trials that suggested a lack of benefit to alpha blocker therapy for Ureteral calculi. Abstract 1491 evaluated tamsulosin vs placebo and Abstract 1410 compared alfuzosin to placbo in untreated patients trying to pass a Ureteral stone. Tamsulosin was no better than placebo in stone passage rate or time to passage, but alfuzosin was associated with less pain, urgency, and frequency during stone passage, but did not facilitate stone passage.

Abstract 1462 reported that most bacteria can bind to silver and heparin coated stents, but not to Triclosan coated stents. Pseudomonas could bind to all stents.

Abstracts 1350 to 1352 reported that increased stone burden was associated with diabetes but the use of shockwave lithotripsy was not associated with diabetes,

Finally, a randomized clinical trial found that Ureteroscopy was superior to shockwave lithotripsy in eliminating upper-tract stones up to 2 cm.

Shockwave: - < 1cm.80% - ≥ 1cm.60%
Ureteroscopy: - < 1cm.100% - ≥ 1cm.80%

Presented by Francis Keeley, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor David P. Wood, MD

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