EFFICACY OF ALFUZOSIN VERSUS CONTROL GROUP IN UPPER URETERIC STONE EXPULSION IN ADULT POPULATION OF LAHORE, PAKISTAN

Fawad Humayun, Ghulam Mujtaba, Muhammad Seerwan, Ghazi Khan, Naseem Javed, Muhammad Adnan

Abstract


Background: Urinary stone disease is one of the commonest urological diseases worldwide. The objective of this study was to compare the efficacy of alfuzosin versus control group in upper ureteric stone expulsion in adult population of district Lahore, Pakistan.

Materials & Methods: This trial was conducted in Department of Urology, Sheikh Zayed Hospital, Lahore, Pakistan form January 2017 to June 2017. All adult patients with upper ureteric stone size 5-10 mm were eligible. Those with multiple stones, having fever, severe pain, history of surgery in past two weeks and growth on urine culture or pyuria were excluded. Experimental and control groups each had 30 patients. Experimental group received Tab. alfuzosin 10 mg daily for four weeks and Tab. diclofenac sodium 50 mg SOS for acute pain. The control group received Tab. diclofenac sodium 50 mg SOS for acute pain. We followed all patients for four weeks for expulsion of ureteric stones by X-ray KUB or CT KUB. Sex, age and stone size were matching variables. Stone expulsion (yes, no) was research variable. We compared count of stone expulsion between two groups by using McNemar chi-square test at alpha 0.5 using GraphPad.

Results: Out of 30 patients in experimental group, 23 (76.67%) were men and seven (23.33%) women and out of 30 in control group, 20 (66.67%) were men and 10 (33.33%) women, almost similar in both groups. Mean age in experimental group was 39.45±10.33 years and in control group it was 37.38±8.28 years, almost similar in both groups. Mean stone size was 7.45±1.47 (5-10) mm in the experimental and 7.28±1.68 (5-10) mm in control group, being comparable in both the groups. In experimental group, stone expulsion was achieved in 23 (76.67%) cases and not in seven (23.33%) cases and in control group, it was achieved in 16 (53.33%) cases and not in 14 (46.67%) cases. There was statistically no significant difference in efficacy of alfuzosin versus control group (p=.1213).

Conclusion: Our study showed no difference in efficacy of alfuzosin versus control group for upper ureteric stone expulsion in adult population of district Lahore, Pakistan.


Keywords


Upper Ureteric Stone; Alfuzosin; Experimental Group; Control Group; Adult; Urology; Urological Diseases; Pakistan.

Full Text:

PDF

References


Marangella M, Petrarulo M, Vitale C, Bagnis C, Berutti S, Ramello A, et al. The primary hyperoxalurias. Contrib to Nephrol 2001 Jan 1;136:11-32. https://doi.org/10.1159/000060176

Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE, et al. Ureteral stones clinical guidelines panel summary report on the management of ureteral calculi. J Urol 1997 Nov;158(5):1915-21. https://doi.org/10.1016/S0022-5347(01)64173-9

Tiselius H-G, Alken P, Buck C, Gallucci M, Knoll T, Sarica K, Türk C. Guidelines on Urolithiasis. Update 2008 Mar [accessed 11 Jan 2021]. Available at: https://uroweb.org/wp-content/uploads/EAU-Guidelines-Urolithiasis-2009.pdf

Miller OF, Kane CJ. Time to stone passage for observed ureteral calculi: a guide for patient education. J Urol 1999 Sep;162(3 Part 1):688-91. https://doi.org/10.1097/00005392-199909010-00014

Shafi H, Moazzami B, Pourghasem M, Kasaeian A. An overview of treatment options for urinary stones. Caspian J Int Med 2016;7(1):1.

Pearle MS, Calhoun EA, Curhan GC. Urologic Diseases of America Project. Urologic diseases in America project: Urolithiasis. J Urol 2005 Mar;173(3):848-5. https://doi.org/10.1097/01.ju.0000152082.14384.d7

Healy KA, Ogan K. Nonsurgical management of urolithiasis: an overview of expulsive therapy. J Endourol 2005 Sep 1;19(7):759-67. https://doi.org/10.1089/end.2005.19.759

Parsons JK, Hergan LA, Sakamoto K, Lakin C. Efficacy of α-blockers for the treatment of ureteral stones. J Urol 2007 Mar;177(3):983-7. https://doi.org/10.1016/j.juro.2006.10.023

Singh A, Alter HJ, Littlepage A. A systematic review of medical therapy to facilitate passage of ureteral calculi. Annals Emerg Med 2007 Nov 1;50(5):552-63. https://doi.org/10.1016/j.annemergmed.2007.05.015

Hollingsworth JM, Rogers MA, Kaufman SR, Bradford TJ, Saint S, Wei JT, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet 2006 Sep 30;368(9542):1171-9. https://doi.org/10.1016/S0140-6736(06)69474-9

Seitz C, Liatsikos E, Porpiglia F, Tiselius H-G, Zwergel U. Medical therapy to facilitate the passage of stones: what is the evidence? Eur Urol 2009;56:455-71. https://doi.org/10.1016/j.eururo.2009.06.012

Itoh Y, Kojima Y, Yasui T, Tozawa K, Sasaki S, Kohri K. Examination of alpha 1 adrenoceptor subtypes in the human ureter. Int J Urol 2007;14:749-53. https://doi.org/10.1111/j.1442-2042.2007.01812.x

Agrawal M, Gupta M, Gupta A, Agrawal A, Sarkari A, Lavania P. Prospective randomized trial comparing efficacy of alfuzosin and tamsulosin in management of lower ureteral stones. Urol J 2009;73:706-9. https://doi.org/10.1016/j.urology.2008.11.013

Pricop C, Novac C, Negru D, Ilie C, Pricop A, Tanase V. Can selective alpha-blockers help the spontaneous passage of the stones located in the uretero-bladder junction? Rev Med Chir Soc Med Nat Iasi 2004;108:128-33.

García MA, Gutiérrez GJD, Martínez MR, Gómez GLS. Use of alfuzosin for expulsion of stones in the distal third of ureter. Actas Urol Esp 2009;33:1005-10. https://doi.org/10.4321/S0210-48062009000900013

Lysander HC, Dominic CKT, Berry TCF, James CML, Chi WF, Michael KWL. Medical expulsive therapy using alfuzosin for patient presenting with ureteral stone less than 10 mm: A prospective randomized controlled trial. Intern J Urol 2011;18:510-14. https://doi.org/10.1111/j.1442-2042.2011.02780.x

Zar JH. Biostatistical Analysis. 5th ed. Englewood Clifts, New Jersey: Prentice-Hall Inc. p.127.

Pegano M, Gauvreau K. Principals of Biostatistics. 2nd ed. Boston, MA, USA: Cengage Learning; 2000:349-52.

Shah HU, Gul H, Khan R, Marwat M. Urethrocutaneous fistula following Snodgrass versus two stage Aivar Bracka repair of distal penile hypospadias in male children: a randomized control trial. Gomal J Med Sci 2018;16:54-8. https://doi.org/10.46903/gjms/16.02.1284

Motulsky HJ. GraphPad, QuickCalcs. McNemar's test to analyze experimental studies. [accessed 11 Jan 2021]. GraphPad Software, San Diego, CA, USA. Availableat at: https://www.graphpad.com/quickcalcs/McNemar1.cfm

Wood KD, Gorbachinsky I, Gutierrez J. Medical expulsive therapy. Ind J Urol 2014;30(1):60-4. https://doi.org/10.4103/0970-1591.124209

Reddy RK. The efficacy of alpha-blockers for expulsion of distal ureteral stones. Intern Surg 2016;3(1):336. https://doi.org/10.18203/2349-2902.isj20160255

Chau L, Tai D, Fung B, Man Li J, Fan C, Wah Li M. Medical expulsive therapy using alfuzosin for patient presenting with ureteral stone less than 10 mm: a prospective randomized controlled trial. Int J Urol 2011;18:510-14. https://doi.org/10.1111/j.1442-2042.2011.02780.x

Agrawal M, Gupta A, Gupta A, Agrawal A, Sarkari P, Lavania. Prospective randomized trial comparing efficacy of alfuzosin and tamsulosin in management of lower ureteral stones. Urol 2009;73:706-9. https://doi.org/10.1016/j.urology.2008.11.013

Ahmed AF, Al-Sayed AY. Tamsulosin versus alfuzosin in the treatment of patients with distal ureteral stones: prospective, randomized, comparative study. Kor J Urol 2010;51:193-7. https://doi.org/10.4111/kju.2010.51.3.193

El Said NO, El Wakeel L, Kamal KM, Morad Ael R. Alfuzosin treatment improves the rate and time for stone expulsion in patients with distal uretral stones: a prospective randomized controlled study. Pharmacotherapy J Hum Pharma Drug Therapy 2015;35(5):470-6. https://doi.org/10.1002/phar.1593


Refbacks

  • There are currently no refbacks.


Copyright (c) 2021. Fawad Humayun, Ghulam Mujtaba, Muhammad Seerwan, Ghazi Khan, Naseem Javed, Muhammad Adnan.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

JOURNAL INDEXING