Posted in medical expulsive therapy, urolithiasis on September 8th, 2009 by Mike – Be the first to comment
European Urology 56(2009) 407-412 (pubmed link)
Hermans T, Sauerman P, Rufibach K, Frauenfelder T, Sulser T, and Strebel RT
A recent randomized double blinded study that did not show different rate of successful stone passage for Tamsulosin vs. placebo (86.7% vs 88.9%), but the Tamsolosin group did pass their stones earlier (7 d vs. 10 d on average) and required less pain medications. It is quite possible that the advantage of the use of alpha blockers relates less to an improved ability to pass the stones, but rather less pain, and therefore more likely to tolerate the time required to pass the stone.
Posted in stents, ureteroscopy on December 30th, 2008 by Mike – Be the first to comment
Beddingfield R, Pedro RN, Hinck B, Kreidberg C, Feia K, Monga M. J Urol. 2009 Jan;181(1):170-6. (PubMed Link)
This randomized, placebo controlled trial assessed the usefulness of Alfuzosin (Uroxatrol) to control stent related symptoms after ureteroscopy. Patients were asked to complete the validated “Ureteral Stent Symptom Questionnaire” before and 3 days after ureteroscopy. Although the patients in the Alfuzosin arm reported less kidney pain during sleep, less frequent use of painkillers for kidney pain, and less interference with life from the kidney pain, the overall amount of narcotics used per day was no different.
A previous study using tamsulosin showed improvement in the “Ureteral Stent Symptom Questionnaire” and Qol scores.A comparison between the two medications might prove useful, as the autonomic effects of the two medications are different as evidenced by the different rates of ejaculatory dysfunction in a prior study.
Posted in laparoscopy, transplant on December 30th, 2008 by Mike – Be the first to comment
Kim JY, Lee KC, Kim HS, Jo YY, Kwak HJ.Surg Endosc. 2008 Dec 6 (PubMed link)
A randomized trial involving 32 patients, half of whom received the control (saline infusion) and the other half received a continuous infusion of diltiazem (2 mug/kg/min). The diltiazem group had significantly higher creatinine clearance during the pneumoperitoneum than the control group, but both groups equalized their urine output by 2 hours postoperative. This may be a useful treatment to prevent renal damage in patients with renal insufficiency who are undergoing laparoscopic procedures. It might also be useful in improving immediate graft function following laparoscopic donor nephrectomy.