Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis
Introduction: Tamsulosin is the most commonly used medical expulsive therapy (MET). However, it does not alleviate ureteral colic. It is important to develop MET that can reduce ureteral colic while maintaining a high stone clearance rate. Silodosin is an α1A adrenoceptor with high affinity and sele...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Urology |
| Online Access: | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=21;epage=26;aulast=Ramadhani |
| _version_ | 1797954988256788480 |
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| author | Muhammad Zaniar Ramadhani Yudhistira Pradnyan Kloping Ilham Akbar Rahman Niwanda Yogiswara Mohammad Ayodhia Soebadi Johan Renaldo |
| author_facet | Muhammad Zaniar Ramadhani Yudhistira Pradnyan Kloping Ilham Akbar Rahman Niwanda Yogiswara Mohammad Ayodhia Soebadi Johan Renaldo |
| author_sort | Muhammad Zaniar Ramadhani |
| collection | DOAJ |
| description | Introduction: Tamsulosin is the most commonly used medical expulsive therapy (MET). However, it does not alleviate ureteral colic. It is important to develop MET that can reduce ureteral colic while maintaining a high stone clearance rate. Silodosin is an α1A adrenoceptor with high affinity and selectivity for the distal ureter, which may reduce ureteral colic and enable stone expulsion for distal ureteral stones. Therefore, we performed this systematic review and meta-analysis to evaluate the efficacy of silodosin as MET and its role in reducing ureteral colic among patients with distal ureteral stones.
Materials and Methods: This research was conducted in accordance with the Cochrane Handbook for Systematic Review and Intervention, in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42021249003). A comprehensive literature search was performed in several databases including Medline, EMBASE, and Scopus up to July 2021 for randomized trials comparing silodosin with placebo for MET. RevMan 5.4 was used for data analysis.
Results: A total of six randomized controlled trials were included in this analysis with a total of 907 patients. Our analysis revealed that the patients who received silodosin had significantly higher stone expulsion rate (SER) (odds ratio [OR] 3.33, 95% confidence interval [CI] 2.34, 4.76, P < 0.01), significantly shorter stone expulsion time (SET) (mean difference −3.79, 95% CI −4.51, −3.06, P < 0.01), and lower analgesic use (OR 0.4, 95% CI 0.23, 0.69, P < 0.01) compared to the group receiving placebo.
Conclusion: Silodosin showed significantly higher SER, lower SET and lower analgesic use in patients with distal ureteral stones as compared to a placebo. |
| first_indexed | 2024-04-10T23:26:16Z |
| format | Article |
| id | doaj.art-4bd2a6cb47c9437c90560a300916e0f7 |
| institution | Directory Open Access Journal |
| issn | 0970-1591 1998-3824 |
| language | English |
| last_indexed | 2024-04-10T23:26:16Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Urology |
| spelling | doaj.art-4bd2a6cb47c9437c90560a300916e0f72023-01-12T12:11:39ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242023-01-01391212610.4103/iju.iju_115_22Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysisMuhammad Zaniar RamadhaniYudhistira Pradnyan KlopingIlham Akbar RahmanNiwanda YogiswaraMohammad Ayodhia SoebadiJohan RenaldoIntroduction: Tamsulosin is the most commonly used medical expulsive therapy (MET). However, it does not alleviate ureteral colic. It is important to develop MET that can reduce ureteral colic while maintaining a high stone clearance rate. Silodosin is an α1A adrenoceptor with high affinity and selectivity for the distal ureter, which may reduce ureteral colic and enable stone expulsion for distal ureteral stones. Therefore, we performed this systematic review and meta-analysis to evaluate the efficacy of silodosin as MET and its role in reducing ureteral colic among patients with distal ureteral stones. Materials and Methods: This research was conducted in accordance with the Cochrane Handbook for Systematic Review and Intervention, in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42021249003). A comprehensive literature search was performed in several databases including Medline, EMBASE, and Scopus up to July 2021 for randomized trials comparing silodosin with placebo for MET. RevMan 5.4 was used for data analysis. Results: A total of six randomized controlled trials were included in this analysis with a total of 907 patients. Our analysis revealed that the patients who received silodosin had significantly higher stone expulsion rate (SER) (odds ratio [OR] 3.33, 95% confidence interval [CI] 2.34, 4.76, P < 0.01), significantly shorter stone expulsion time (SET) (mean difference −3.79, 95% CI −4.51, −3.06, P < 0.01), and lower analgesic use (OR 0.4, 95% CI 0.23, 0.69, P < 0.01) compared to the group receiving placebo. Conclusion: Silodosin showed significantly higher SER, lower SET and lower analgesic use in patients with distal ureteral stones as compared to a placebo.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=21;epage=26;aulast=Ramadhani |
| spellingShingle | Muhammad Zaniar Ramadhani Yudhistira Pradnyan Kloping Ilham Akbar Rahman Niwanda Yogiswara Mohammad Ayodhia Soebadi Johan Renaldo Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis Indian Journal of Urology |
| title | Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis |
| title_full | Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis |
| title_fullStr | Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis |
| title_full_unstemmed | Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis |
| title_short | Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis |
| title_sort | silodosin as a medical expulsive therapy for distal ureteral stones a systematic review and meta analysis |
| url | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=21;epage=26;aulast=Ramadhani |
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