title: Efficacy of selective α1A adrenoceptor antagonist silodosin in the medical expulsive therapy for ureteral stones.
abstract: Recently, we reported that α1A adrenoceptor (AR) is the main participant in phenylephrine-induced human ureteral contraction. We therefore decided to carry out a prospective randomized study to evaluate the effects of silodosin, a selective α1A AR antagonist, as a medical expulsive therapy for ureteral stones. A total of 187 male patients, who were referred to our department for the management of symptomatic unilateral ureteral calculi of less than 10 mm, were randomly divided into two groups: group A (92 patients), who were instructed to drink 2 L of water daily, and group B (95 patients), who received the same instruction and were also given silodosin (8 mg/daily) for a maximum of 8 weeks. Expulsion rate, mean expulsion time and need for analgesics were examined. Overall, the mean expulsion time was 15.19 ± 7.14 days for group A and 10.27 ± 8.35 days for group B (P = 0.0058). In cases involving distal ureteral stones, the mean expulsion time was 13.40 ± 5.90 and 9.29 ± 5.91 days, respectively (P = 0.012). For stones of 1-5 mm in diameter, the mean expulsion time was 14.28 ± 6.35 and 9.56 ± 8.45 days, respectively (P = 0.017). For stones of 6-9 mm in diameter, the stone expulsion rate was 30.4% and 52.2% (P = 0.036), and the mean expulsion time was 21.00 ± 9.9 and 11.33 ± 8.31 days, respectively (P = 0.038). Herein, we report the first on silodosin in the management of ureteral lithiasis. Our findings suggest that silodosin might have potential as a medical expulsive therapy for ureteral stones.
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan. yasunori2009@gmail.com
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Itoh
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okada
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yasui
authors.forename: Shuzo
authors.initials: S
authors.lastname: Hamamoto
authors.forename: Masahito
authors.initials: M
authors.lastname: Hirose
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tozawa
authors.forename: Shoichi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D004326:Drinking; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000188:drug therapy*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D000700:Analgesics; D007211:Indoles; C095285:silodosin