Yuksel Mustafa, Yilmaz Serdar, Tokgoz Husnu, Yalcinkaya Soner, Baş Serkan, Ipekci Tümay, Yildiz Ali, Ates Nihat, Savas Murat
Department of Urology, Antalya Training and Research Hospital Antalya, Turkey.
Department of Urology, Konya Training and Research Hospital Konya, Turkey.
Int J Clin Exp Med. 2015 Oct 15;8(10):19086-92. eCollection 2015.
Few studies have investigated the efficacy of silodosin, a recently introduced selective alpha 1-A adrenoceptor antagonist, in medical expulsive therapy (MET) for ureteral calculi. The results of these studies, which all evaluated the efficacy of 8 mg/day, indicate that silodosin is a potential treatment for ureteral calculi. This study investigated the efficacy of 4 mg/day of silodosin for MET of distal ureteral stones 4 to 10 mm in diameter.
After 70 patients had been randomized into 2 groups of 35 patients each, both the control and experimental groups (groups 1 and 2, respectively) were advised to take 75 mg/day of diclofenacsodiumas needed for pain relief but only the experimental group to take 4 mg/day of silodosin. After 21 days, the groups were compared regarding the stone expulsion rate and duration, number of renalcolicepisodes, and analgesicdosage.
The median expulsion rates were 71.4% and 91.4% in groups 1 and 2, respectively, and the difference between them was significant (P=0.031). The median expulsion durations were 12.91±6.14 and 8.03±4.99 days, respectively, and the difference between them was significant (P<0.001). No significant differences were found regarding the median number of renal colic episodes or median analgesic dosage. While no patients in group 1 experienced side effects, 5 patients (14%) in group 2 experienced retrograde ejaculation.
These results indicate that 4 mg/day of silodos in facilitates the expulsion of distal ureteral stones 4 to 10 mm in diameter but does not significantly reduce the number of renal colic episodes or analgesic dosage.
很少有研究探讨西洛多辛(一种最近推出的选择性α1 - A肾上腺素能受体拮抗剂)在输尿管结石药物排石疗法(MET)中的疗效。这些研究均评估了每日8毫克剂量的疗效,结果表明西洛多辛是输尿管结石的一种潜在治疗方法。本研究调查了每日4毫克西洛多辛用于直径4至10毫米的输尿管下段结石药物排石疗法的疗效。
70例患者被随机分为两组,每组35例。对照组和试验组(分别为第1组和第2组)均根据需要服用75毫克/日双氯芬酸钠以缓解疼痛,但仅试验组服用4毫克/日西洛多辛。21天后,比较两组的结石排出率和排出时间、肾绞痛发作次数以及镇痛药物剂量。
第1组和第2组的结石排出率中位数分别为71.4%和91.4%,两组之间差异有统计学意义(P = 0.031)。结石排出时间中位数分别为12.91±6.14天和8.03±4.99天,两组之间差异有统计学意义(P<0.001)。肾绞痛发作次数中位数和镇痛药物剂量中位数方面未发现显著差异。第1组无患者出现副作用,而第2组有5例患者(14%)出现逆行射精。
这些结果表明,每日4毫克西洛多辛有助于直径4至10毫米的输尿管下段结石排出,但不能显著减少肾绞痛发作次数或镇痛药物剂量。