title: A comparison of nifedipine and tamsulosin as medical expulsive therapy for the management of lower ureteral stones without ESWL.
abstract: Administration of nifedipine or tamsulosin has been suggested to augment stone expulsion rates. We aimed to compare the stone expulsion rates and adverse effects associated with the use of nifedipine or tamsulosin as medical expulsive therapy (MET) for the management of lower ureteral stones (LUS) without extracorporeal shock wave lithotripsy (ESWL) via a literature review and meta-analysis. Relevant randomized controlled trials (RCTs) were identified from the Medline, EMBASE, Cochrane CENTRAL, and Google Scholar databases. Finally, a total of 7 RCTs with 3897 patients were included. Our meta-analysis showed that tamsulosin could significantly increase the stone expulsion rate relative to nifedipine in patients with LUS (random-effects model; risk ratio [RR] = 0.81; 95% confidence interval [CI] = 0.75-0.88; P < 0.00001). The subgroup analysis indicated no statistically significant difference between the drugs with regard to minor or major adverse effects (fixed-effect model; RR = 1.19, 95% CI = 0.91-1.54, P = 0.20; and RR = 1.63, 95% CI = 0.22-11.82, P = 0.63, respectively). This meta-analysis demonstrated that tamsulosin was more effective than nifedipine in patients with LUS, as evidenced by the higher stone expulsion rate. Tamsulosin treatment should therefore be considered for patients with LUS.
authors.affiliation: From the Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Dehong
authors.initials: D
authors.lastname: Cao
authors.affiliation: From the Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Yang
authors.affiliation: From the Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Liangren
authors.initials: L
authors.lastname: Liu
authors.affiliation: From the Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Haichao
authors.initials: H
authors.lastname: Yuan
authors.affiliation: From the Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Shenqiang
authors.initials: S
authors.lastname: Qian
authors.affiliation: From the Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Lv
authors.affiliation: From the Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Pin
authors.initials: P
authors.lastname: Han
authors.affiliation: From the Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D014545:Urinary Calculi / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D013449:Sulfonamides; D000077409:Tamsulosin; D009543:Nifedipine