Cho HJ et al, 2013: Efficacy of alfuzosin after shock wave lithotripsy for the treatment of ureteral calculi
Cho HJ, Shin SC, Seo do Y, Min DS, Cho JM, Kang JY, Yoo TK
Department of Urology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
PURPOSE: We evaluated the efficacy of alfuzosin for the treatment of ureteral calculi less than 10 mm in diameter after extracorporeal shock wave lithotripsy (ESWL).
MATERIALS AND METHODS: A randomized, single-blind clinical trial was performed prospectively by one physician between June 2010 and August 2011. A total of 84 patients with ureteral calculi 5 to 10 mm in diameter were divided into two groups. Alfuzosin 10 mg (once daily) and loxoprofen sodium 68.1 mg (as needed) were prescribed to group 1 (n=41), and loxoprofen sodium 68.1 mg (as needed) only was prescribed to group 2 (n=44). The drug administration began immediately after ESWL and continued until stone expulsion was confirmed up to a maximum of 42 days after the procedure.
RESULTS: Thirty-nine of 41 (95.1%) patients in group 1 and 40 of 43 (93.0%) patients in group 2 ultimately passed stones (p=0.96). The number of ESWL sessions was 1.34±0.65 and 1.41±0.85 in groups 1 and 2, respectively (p=0.33). The patients who required analgesics after ESWL were 8 (19.5%) in group 1 and 13 (30.2%) in group 2 (p=0.31). Visual analogue scale pain severity scores were 5.33±1.22 and 6.43±1.36 in groups 1 and 2, respectively (p=0.056). The time to stone expulsion in groups 1 and 2 was 9.5±4.8 days and 14.7±9.8 days, respectively (p=0.005). No significant adverse effects occurred.
CONCLUSIONS: The use of alfuzosin in combination with ESWL seems to facilitate stone passage and to reduce the time of stone expulsion but does not affect the stone-free rate.
Korean J Urol. 2013 Feb;54(2):106-10. doi: 10.4111/kju.2013.54.2.106. Epub 2013 Feb 18.
PMID:23550174[PubMed] PMCID:PMC3580299. FREE ARTICLE
In this report alfuzosin administration after SWL resulted in a shorter time to stone expulsion of stone material from the ureter. The result is similar to that in numerous other reports in the literature. The stone-free rates are high and it is not surprising that it was possible to demonstrated differences in that regard. Most urologists have probably included alpha-receptor antagonists in the routine treatment after SWL for ureteral stones. What we really want to know from future studies is how this form of treatment affects fragment clearance from the kidney.