title: Efficacy of three different alpha 1-adrenergic blockers and hyoscine N-butylbromide for distal ureteral stones.
abstract: OBJECTIVE
  To evaluate hyoscine N-butyl bromide (HBB) and three different alpha-1 blockers in the treatment of distal ureteral stones.
  
  
  METHODS
  A total of 140 patients with stones located in the distal tract of the ureter with stone diameters of 5 to 10mm were enrolled in the present study and were randomized into 4 equal groups. Group 1 received HBB, Group 2 received alfuzosin, Group 3 received doxazosin and Group 4 received terazosin. The subjects were prescribed diclofenac injection (75 mg) intramuscularly on demand for pain relief and were followed-up after two weeks with x-rays of the kidneys, ureters, bladder and urinary ultrasonography every week. The number of pain episodes, analgesic dosage and the number of days of spontaneous passage of the calculi through the ureter were also recorded.
  
  
  RESULTS
  The average stone size for groups 1, 2, 3 and 4 was comparable (6.13, 5.83, 5.59 and 5.48 mm respectively). Stone expulsion was observed in 11%, 52.9%, 62%, and 46% in groups 1, 2, 3 and 4 respectively. The average time to expulsion was 10.55 ± 6.21 days in group 1, 7.38 ± 5.55 days in group 2, 7.85 ± 5.11 days in group 3 and 7.45 ± 5.32 days in group 4. Alpha blockers were found to be superior to HBB (p < 0.05).
  
  
  CONCLUSIONS
  Medical treatment of distal ureteral calculi with alfuzosin, doxazosin and terazosin resulted in a significantly increased stone-expulsion rate and decreased expulsion time when compared with HBB. HBB seems to have a negative effect on stone-expulsion rate.
authors.affiliation: Istanbul Goztepe Training Hospital, Department of 2nd Urology, Istanbul, Turkey. gurbuzcenk@yahoo.com
authors.forename: M Cenk
authors.initials: MC
authors.lastname: Gurbuz
authors.forename: Haci
authors.initials: H
authors.lastname: Polat
authors.forename: Lutfi
authors.initials: L
authors.lastname: Canat
authors.forename: Mert
authors.initials: M
authors.lastname: Kilic
authors.forename: Turhan
authors.initials: T
authors.lastname: Caskurlu
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002086:Butylscopolammonium Bromide / Q000627:therapeutic use*; D017292:Doxazosin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011446:Prospective Studies; D011799:Quinazolines / Q000627:therapeutic use*; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000188:drug therapy*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D011799:Quinazolines; D002086:Butylscopolammonium Bromide; C041226:Terazosin; C047638:alfuzosin; D017292:Doxazosin; D011224:Prazosin