α-Blocker Treatment of Urolithiasis
2006; Elsevier BV; Volume: 50; Issue: 2 Linguagem: Inglês
10.1016/j.eururo.2006.02.047
ISSN1873-7560
AutoresMartin C. Michel, Jean de la Rosette,
Tópico(s)Pediatric Urology and Nephrology Studies
ResumoUrolithiasis affects a relevant part of the population, and its incidence is increasing. Shock wave lithotripsy (SWL) and ureteroscopy are effective instrumental treatments for ureteral stones. However, the possible morbidity, significant cost and the need for highly specialized equipment and special expertise raise the question whether these treatments are indeed the most attractive options to meet the increasing demand. One may conclude ‘yes’ since the classic conservative treatment with hydration and non-steroidal anti-inflammatory drugs such as indomethacin alone is insufficient to yield rapid stone expulsion and to prevent colic and pain. Since non-interventional treatments are the most appealing to patients, however, there is a large interest in alternative medical treatment modalities. One possible pathway for medical treatment is anti-inflammatory and anti-oedematous treatment by glucocorticoids. Another option is the relaxation of ureteral smooth muscle (eg, by a1-adrenoceptor antagonists (a-blockers) or Ca entry blockers. A study [1] in this issue of the journal has investigated the individual contributions of an a-blocker, a glucocorticoid and their combination in the expulsive therapy for distal ureter stones, on the basis of several previous studies that have tested a-blockers when given on top of glucocorticoids such as deflazacort [2–5]. While the available studies on the use of ablockers in the treatment of urolithiasis did not always reach statistical significance with regard to overall expulsion rates, they have consistently shown a-blockers to be more effective than standard treatments with regard to expulsion time, colic
Referência(s)