Title: Role of Alfuzosin in Spontaneous Passage of Distal Ureteric Calculi
Authors: Dr Sanjay Kumar Bhat, Dr Rahul Bhushan, Dr Nippun Chakarbarty
DOI: http://dx.doi.org/10.18535/jmscr/v3i11.07
Medical expulsion therapy has been shown to be a useful adjunct to observation in the management of ureteral stones. Alpha-1-adrenergic receptor antagonists have been studied in this role. Alpha-1 receptors are located in the human ureter, especially the distal ureter. Alpha-blockers have been demonstrated to increase expulsion rates of distal ureteral stones, decrease time to expulsion, and decrease need for analgesia during stone passage. Alpha-blockers promote stone passage in patients receiving shock wave lithotripsy, and may be able to relieve ureteral stent-related symptoms. In the appropriate clinical scenario, the use of α-blockers is recommended in the conservative management of distal ureteral stones. 1. Johnson CM et al. Renal stone and epidemiology: a 25 year study in Rochester, Minnesota. Kidney Int. 1979;16:624-631 2. Rugendorff EW, Wilson T. The history of urology on prostate stamps and casncellations. The journal of Urology 1997;158(4):1335-1339 3. Muldoon LD, Resnick MI: Secondry Urolithiasis. Endocrinol Metab Clin North Am 1990;19:909 4. Carr RJ: a new theory on the formation of renal calculi. Br J Urol. 1954;26:105 5. Hollingsworth JM, Rogers MAM, Kaufman SR, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet. 2006;368:1171–1179. [PubMed] 6. Malin JM, Deane RF, Boyarsky S. Characterisation of adrenergic receptors in human ureter. Br J Urol.1970;42:171–174. [PubMed] 7. Sigala S, Dellabella M, Milanese G, et al. Evidence for the presence of alpha1 adrenoceptor subtypes in the human ureter. Neurourol Urodynamics. 2005;24:142–148. [PubMed] 8. Davenport K, Timoney AG, Keeley FX. A comparative in vitro study to determine the beneficial effect of calcium-channel and alpha(1)-adrenoceptor antagonism on human ureteric activity. BJU Int. 2006;98:651–655. [PubMed] 9. Morita T, Wada I, Saeki H, et al. Ureteral urine transport: changes in bolus volume, peristaltic frequency, intraluminal pressure and volume of flow resulting from autonomic drugs.J Urol. 1987;137:132–135. [PubMed] 10. Kubacz GJ, Catchpole BN. The role of adrenergic blockade in the treatment of ureteral colic. J Urol.1972;107:949–951. [PubMed]Abstract
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