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J Urol. 2008 Jun;179(6):2244-7; discussion 2247. doi: 10.1016/j.juro.2008.01.141. Epub 2008 Apr 18.

Alfuzosin stone expulsion therapy for distal ureteral calculi: a double-blind, placebo controlled study.

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1
Department of Urology, University of Minnesota, Minneapolis, Minnesota, USA.

Abstract

PURPOSE:

We evaluated the efficacy of alfuzosin as medical expulsive therapy for distal ureteral stone passage.

MATERIALS AND METHODS:

A total of 76 patients with a distal ureteral calculus provided consent for the study. Patients were randomized between placebo and study medication, and investigators and patients were blinded to the randomization scheme. Followup was done on a weekly basis and continued until the patient was rendered stone-free. The patient blood pressure, discomfort level, stone position on imaging, number of remaining pills and any adverse events were assessed. Statistical analysis was performed with the Student t test with p <0.05 considered significant.

RESULTS:

The overall spontaneous stone passage rate was 75%, including 77.1% for placebo and 73.5% for alfuzosin (p = 0.83). Mean +/- SD time needed to pass the stone was 8.54 +/- 6.99 days for placebo vs 5.19 +/- 4.82 days for alfuzosin. (p = 0.003). There was no difference in the size or volume of stones that passed spontaneously between the placebo and alfuzosin arms, as measured on baseline computerized tomography (4.08 +/- 1.17 and 3.83 +/- 0.95 mm, p = 0.46) and by a digital caliper after stone expulsion (3.86 +/- 1.76 and 3.91 +/- 1.06 mm, respectively, p = 0.57). When comparing the improvement from the baseline pain score, the alfuzosin arm experienced a greater decrease in pain score in the days after the initial emergency department visit to the date of stone passage (p = 0.0005).

CONCLUSIONS:

Alfuzosin improves the patient discomfort associated with stone passage and decreases the time to distal ureteral stone passage but it does not increase the rate of spontaneous stone passage.

PMID:
18423747
DOI:
10.1016/j.juro.2008.01.141
[Indexed for MEDLINE]

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