Medical expulsive therapy using alfuzosin for patient presenting with ureteral stone less than 10 mm: A prospective randomized controlled trial - Abstract

Urology Division, Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.


To assess the spontaneous passage rate for patients being treated with alfuzosin 10 mg daily after presenting with an acute ureteral stone compared with a control group, and to assess the respective pain control status.

This was a prospective randomized controlled trial. Patients presenting with an acute ureteral stone (size 5-10 mm) were enrolled and randomized into a medical expulsive therapy (MET) group or control group. The MET group received alfuzosin slow release (SR) 10 mg daily for 4 weeks and dologesic (paracetamol + dextropropoxyphene, four tablets daily on demand) for 2 weeks. The control group received the same analgesics for 2 weeks only. Diclofenac sodium SR 100 mg daily for 2 weeks was added in case of suboptimal pain control. All the patients were assessed through phone interview at week 2 and with kidney-ureter-bladder X-ray at week 5 to check for any evidence of stone passage.

A total of 67 patients were included in the analysis. The overall spontaneous passage rate was increased by 31.8% with MET (P = 0.006). For an upper ureteral stone, the rate was increased by 51.3% (P = 0.01). The MET group used significantly less dicolofenac sodium (1.5 tablets vs 6.7 tablets, P = 0.031).

MET using alfuzosin SR 10 mg daily is effective to enhance the ureteral stone spontaneous passage rate, particularly for upper ureteral stones. Fewer analgesic drugs are consumed and more patients can avoid ureteroscopic lithotripsy and/or extracorporeal shock wave lithotripsy.

Written by:
Chau LH, Tai DC, Fung BT, Li JC, Fan CW, Li MK.   Are you the author?

Reference: Int J Urol. 2011 May 18. Epub ahead of print.
doi: 10.1111/j.1442-2042.2011.02780.x

PubMed Abstract
PMID: 21592234 Stone Disease Section



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