title: Adjunctive medical therapy with α-blocker after extracorporeal shock wave lithotripsy of renal and ureteral stones: a meta-analysis.
abstract: BACKGROUND
  Although some trials assessed the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after extracorporeal shock wave lithotripsy (ESWL), the role of the α-blocker in facilitating upper urinary calculi expulsion after ESWL remain controversial.
  
  
  OBJECTIVE
  To determine the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after ESWL.
  
  
  METHODS
  A literature search was carried out using the PubMed database, EMBASE and the Cochrane Library database to identify relevant studies. Two reviewers independently extracted data and assessed methodological quality. Pooled effect estimates were obtained using a fixed- and random-effects meta-analysis.
  
  
  RESULTS
  The meta-analysis included 23 RCTs, α-blocker significantly enhanced expulsion rate of upper urinary tract calculi after ESWL (P<0.00001; RR 1.21; 95% CI 1.12-1.31), significantly promoted steinstrasse expulsion (P=0.03; RR 1.25; 95% CI 1.03-1.53), significantly shortened the discharge time of upper urinary tract calculi (P=0.0001; MD -2.12; 95% CI -3.20--1.04), significantly reduced the patient's pain VAS score (P=0.001; RR -1.0; 95% CI -1.61--0.39). Compared with the control group, dizziness (P=0.002; RR 5.48; 95% CI 1.91-15.77), anejaculation (P=0.02; RR 12.17; 95% CI 1.61-91.99) and headache (P=0.04; RR 4.03; 95% CI 1.04-15.72) in the α-blocker group was associated with a higher incidence.
  
  
  CONCLUSIONS
  Treatment with α-blocker after ESWL appears to be effective in enhancing expulsion rate of upper urinary tract calculi, shortening the discharge time of upper urinary tract calculi, reducing the patient's pain. The side effects of α-blocker were light and few.
authors: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, P. R. China.
authors: Mingchao
authors: M
authors: Li
authors: Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China.
authors: Zhengyun
authors: Z
authors: Wang
authors: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, P. R. China.
authors: Jun
authors: J
authors: Yang
authors: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, P. R. China.
authors: Xiaolin
authors: X
authors: Guo
authors: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, P. R. China.
authors: Tao
authors: T
authors: Wang
authors: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, P. R. China.
authors: Shaogang
authors: S
authors: Wang
authors: Department of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Chunping
authors: C
authors: Yin
authors: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, P. R. China.
authors: Jihong
authors: J
authors: Liu
authors: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, P. R. China.
authors: Zhangqun
authors: Z
authors: Ye
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods; D016017:Odds Ratio; D017594:Publication Bias; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*
chemical_list: D000317:Adrenergic alpha-Antagonists