Stone, Urinary
Conditions
Brief summary
The spontaneous passage rate for ureteral stone less than 1cm causing acute ureteral obstruction is about 50%. Previous Cochrane review has concluded that alpha blocker is likely to increase stone passage rate, reduce time to stone passage, analgesic use and hospitalisations. The European Association of Urology Guideline also recommends giving alpha blockers as Medical Expulsive Therapy to patients with distal ureteric stones \>5mm. However there is heterogeneity in different alpha blockers. Silodosin is a recently introduced selective alpha blocker which has a much higher selectivity for the alpha-1-A receptor (17-fold compared with tamsulosin). From previous animal studies, ureteral contraction is mainly mediated by the alpha-1-A receptor, hence silodosin maybe more effective in increasing stone passage compared with tamsulosin. Previous studies and meta-analysis has shown superiority of silodosin over tamsulosin on earlier stone passage and less pain. However, there is no data on Chinese population. The investigators would like to compare the efficacy and side effect profile of Silodosin versus tamsulosin on improving stone passage rate and hence reduce rate of further intervention for stone clearance.
Interventions
DRUGSilodosin
Cap silodosin for medical expulsion therapy
DRUGTamsulosin
Cap tamsulosin
Sponsors
Princess Margaret Hospital, Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Presented with radio-opaque ureteric stone of size 5mm to 10mm on KUB * Patients who can understand the study protocol and comply with the followup schedule
Exclusion criteria
* Radiolucent stone * Paper thin cortex * Non-functioning kidney * Renal insufficiency (serum creatinine greater than 1.8 mg/dl or 160umol/dL) * Concurrent urosepsis * Current \[alpha\]-blocker usage, Ca channel blocker, steroid * Pregnancy * Age \< 18 * History of ureteral stricture * History of ureteric stone treatment within 2 years * Allergic reaction to the study medication * Unable to Consent * Patient on JJ stent or PCN drainage
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stone free rate | FU at week 2 | Wet KUB for stone passage & RFT before FU (check 3/7 before the last FU) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain control | FU at week 2 | Use of analgesics and VAS pain scale (0-10) |
Countries
Hong Kong
Contacts
Primary ContactYI CHIU, MBBS(HK)
Outcome results
None listed