Tsuzaka Y et al, 2011: Naftopidil vs silodosin in medical expulsive therapy for ureteral stones: A randomized controlled study in Japanese male patients
Tsuzaka Y, Matsushima H, Kaneko T, Yamaguchi T, Homma Y
Department of Urology, Tokyo Metropolitan Police Hospital Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
The aim of the present study was to compare the efficacy of the selective α(1D) -adrenoceptor antagonist naftopidil and the selective α(1A) -adrenoceptor antagonist silodosin (as an example) in the management of ureteral stones in Japanese male patients. A total of 74 patients with symptomatic ≤10 mm ureteral stones were enrolled in a prospective study and randomized into two groups: Group 1 received 50 mg naftopidil daily, whereas Group 2 received 8 mg silodosin daily. Patients were followed-up for up to 6 weeks. The primary endpoint was stone expulsion rate and secondary endpoints were stone expulsion time, the rate of interventions, such as transurethral ureterolithotripsy, extracorporeal shock wave lithotripsy, or ureteral stenting, and side effects. There were no significant differences between the two groups with respect to age, stone size, and location. The stone expulsion rate was 61% and 84% in the naftopidil and silodosin groups, respectively (P = 0.038). No significant differences were noted in stone expulsion time or the rate of interventions between the two groups. The findings suggest that α(1A) -adrenoceptor blockade was clinically superior for stone expulsion our study population.
© 2011 The Japanese Urological Association.
Int J Urol. 2011 Nov;18(11):792-5. doi: 10.1111/j.1442-2042.2011.02850.x. Epub 2011 Sep 14
PMID: 21917021 [PubMed - in process]. FREE ARTICLE
This prospective randomized study shows a significantly better expulsion rate (84%) of ureteral stones with the highly selective a1Aadrenoceptor Antagonist silodosin than with the relatively selective a1D-adrenoceptor Antagonist naftopidil (61%). Consequently one would also expect a significant difference in the frequency of post SWL interventions in both groups. This difference was not significant. It seems that the number of patients was too small to give conclusive results to the study.