Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
Int J Urol. 2011 Sep;18(9):672-4. doi: 10.1111/j.1442-2042.2011.02810.x. Epub 2011 Jun 26.
Recently, we reported that α1A adrenoceptor (AR) is the main participant in phenylephrine-induced human ureteral contraction. We therefore decided to carry out a prospective randomized study to evaluate the effects of silodosin, a selective α1A AR antagonist, as a medical expulsive therapy for ureteral stones. A total of 187 male patients, who were referred to our department for the management of symptomatic unilateral ureteral calculi of less than 10 mm, were randomly divided into two groups: group A (92 patients), who were instructed to drink 2 L of water daily, and group B (95 patients), who received the same instruction and were also given silodosin (8 mg/daily) for a maximum of 8 weeks. Expulsion rate, mean expulsion time and need for analgesics were examined. Overall, the mean expulsion time was 15.19 ± 7.14 days for group A and 10.27 ± 8.35 days for group B (P = 0.0058). In cases involving distal ureteral stones, the mean expulsion time was 13.40 ± 5.90 and 9.29 ± 5.91 days, respectively (P = 0.012). For stones of 1-5 mm in diameter, the mean expulsion time was 14.28 ± 6.35 and 9.56 ± 8.45 days, respectively (P = 0.017). For stones of 6-9 mm in diameter, the stone expulsion rate was 30.4% and 52.2% (P = 0.036), and the mean expulsion time was 21.00 ± 9.9 and 11.33 ± 8.31 days, respectively (P = 0.038). Herein, we report the first on silodosin in the management of ureteral lithiasis. Our findings suggest that silodosin might have potential as a medical expulsive therapy for ureteral stones.
最近，我们报道了α1A 肾上腺素能受体（AR）是去氧肾上腺素诱导人输尿管收缩的主要参与者。因此，我们决定进行一项前瞻性随机研究，评估选择性α1A AR 拮抗剂 silodosin 作为输尿管结石的医学排出疗法的效果。共有 187 名男性患者因单侧输尿管结石小于 10mm 而就诊于我院，他们被随机分为两组：A 组（92 例），嘱其每日饮水 2L；B 组（95 例），给予相同的指导，并接受 silodosin（每日 8mg）治疗，最长 8 周。检查排石率、平均排石时间和需要使用镇痛药的情况。总的来说，A 组的平均排石时间为 15.19 ± 7.14 天，B 组为 10.27 ± 8.35 天（P = 0.0058）。在涉及输尿管下段结石的情况下，平均排石时间分别为 13.40 ± 5.90 和 9.29 ± 5.91 天（P = 0.012）。对于直径为 1-5mm 的结石，平均排石时间分别为 14.28 ± 6.35 和 9.56 ± 8.45 天（P = 0.017）。对于直径为 6-9mm 的结石，排石率分别为 30.4%和 52.2%（P = 0.036），平均排石时间分别为 21.00 ± 9.9 和 11.33 ± 8.31 天（P = 0.038）。在此，我们首次报道了 silodosin 在治疗输尿管结石中的应用。我们的研究结果表明，silodosin 可能具有作为输尿管结石的医学排出疗法的潜力。
