MP41-06 ADMINISTRATION OF THE SELECTIVE ALPHA 1A ADRENOCEPTOR ANTAGONIST SILODOSIN FACILITATES EXPULSION OF SIZE 5 - 10 MM DISTAL URETERAL STONES, AS COMPARED TO CONTROL.

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You have accessJournal of UrologyStone Disease: Medical Therapy1 Apr 2015MP41-06 ADMINISTRATION OF THE SELECTIVE ALPHA 1A ADRENOCEPTOR ANTAGONIST SILODOSIN FACILITATES EXPULSION OF SIZE 5 - 10 MM DISTAL URETERAL STONES, AS COMPARED TO CONTROL. Yasunori Itoh, Atsushi Okada, Kazumi Taguchi, Yasuhiko Hirose, Yasuhiro Fujii, Takahiro Kobayashi, Masayuki Usami, Shuzo Hamamoto, Masahito Hirose, Takahiro Yasui, Keiichi Tozawa, Shoichi Sasaki, Yutaro Hayashi, and Kenjiro Kohri Yasunori ItohYasunori Itoh More articles by this author , Atsushi OkadaAtsushi Okada More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Yasuhiko HiroseYasuhiko Hirose More articles by this author , Yasuhiro FujiiYasuhiro Fujii More articles by this author , Takahiro KobayashiTakahiro Kobayashi More articles by this author , Masayuki UsamiMasayuki Usami More articles by this author , Shuzo HamamotoShuzo Hamamoto More articles by this author , Masahito HiroseMasahito Hirose More articles by this author , Takahiro YasuiTakahiro Yasui More articles by this author , Keiichi TozawaKeiichi Tozawa More articles by this author , Shoichi SasakiShoichi Sasaki More articles by this author , Yutaro HayashiYutaro Hayashi More articles by this author , and Kenjiro KohriKenjiro Kohri More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1634AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recently, we reported that alpha 1A 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 alpha 1A AR antagonist, as a medical expulsive therapy (MET) for distal ureteral stones. METHODS A total of 112 male patients, who were referred to our department for the management of symptomatic unilateral distal ureteral calculi of less than 10 mm, were randomly divided into two groups: group A (56 patients) who were instructed to drink 2 L of water daily and group B (56 patients) who received the same instruction and were also given silodosin (8 mg/daily) for a maximum of 4 weeks. Expulsion rate, expulsion time and need for analgesics were examined. RESULTS The expulsion rate was 55.3% (56 patients) for group A and 72.7% (55 patients) for group B (P = 0.106). The expulsion rate for < 5 mm was 92.9% (28 patients) for group A and 69.2% (26 patients) for group B (P =0.053). The expulsion rate for > or = 5 mm was 17.9% (28 patients) for group A and 75.9% (29 patients) for group B (P =0.001). The expulsion time was 13.40 ± 5.90 and 9.29 ± 5.91 days, respectively (P = 0.012). Analgesics were required 1.5 ± 3.1 and 0.3 ± 0.9 times, respectively (P = 0.382). Stone size in expulsion cases was 3.64 ± 1.25 and 5.23 ± 2.32 mm, respectively (P = 0.003). In all stone sizes, group B showed high expulsion rate (Fig.). CONCLUSIONS Due to the high likelihood of spontaneous passage of stones up to 5 mm, MET is less likely to increase the stone-free rate. Here, we have shown that MET for distal ureteral stones by silodosin was effective for stones ≥5 mm. Silodosin is used in Japan, the United States, Korea, Germany, Lebanon, Ireland, Spain, France, Portugal, Belgium, Romania, Taiwan, Italy, Greece, Netherland, Russia, Czech, Slovakia, Canada, Bulgaria, Cyprus, Turkey, Poland, Ukraine, Georgia, and China. We believe that silodosin might have potential as a MET for distal ureteral stones. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e502 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasunori Itoh More articles by this author Atsushi Okada More articles by this author Kazumi Taguchi More articles by this author Yasuhiko Hirose More articles by this author Yasuhiro Fujii More articles by this author Takahiro Kobayashi More articles by this author Masayuki Usami More articles by this author Shuzo Hamamoto More articles by this author Masahito Hirose More articles by this author Takahiro Yasui More articles by this author Keiichi Tozawa More articles by this author Shoichi Sasaki More articles by this author Yutaro Hayashi More articles by this author Kenjiro Kohri More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...