Release date: 2016-12-07 About one in every 11 Americans gets kidney stones in their lifetime, causing pain, sometimes losing their jobs, and usually spending a lot of money. For two-thirds of patients with kidney stones that don't just need extra water through the stones, doctors are eager to find non-surgical methods to help them. Contemporary practice guidelines recommend the use of drugs called alpha blockers to promote stone passage. These include drugs such as tamsulosin, known as Flomax. However, a recent multicenter study of 1136 British subjects questioned the effectiveness of alpha blockers. Now, a new medical literature review suggests that alpha-blockers may be useful in certain situations. Published on BMJ on December 1st, formerly known as the British Medical Journal. "If we can promote the passage of kidney stones without surgery, we can prevent our patients from the extra pain and risk of surgery," said John M. Hollingsworth, MD, associate professor of urology at the University of Michigan School of Medicine. “The 2015 study did not show a significant difference between alpha blockers and placebo, and we want to explore this issue further.†Joint research Hollingsworth and his team added the 2015 study to the background of other kidney stone studies, combining a total of 55 randomized controlled trials comparing alpha blockers with placebo or control. Then they considered the size and location of the stone in 5,990 subjects to see if there was a factor that affected the smooth passage of the stone. "We found that the role of alpha blockers was successful, but it was mainly benefited by patients with larger kidney stones," said Dr. Benjamin K. Canales, associate professor of urology at the University of Florida School of Medicine. The study reported that using alpha-blockers to clear larger stones increased the risk by 57%, but not for small stones. The location of the stones and the type of alpha blockers used had no effect. "It's important not to compromise the low-risk options that may benefit patients," said senior author Philipp Dahm, professor of urology at the University of Minnesota School of Medicine. "Our findings indicate that suppliers should consider the supply of alpha-blockers." Impact on clinical care "This data can help me better identify patients who might benefit from alpha-blockers," Hollingsworth said. "It is important to consider the size of the stone when deciding whether to recommend alpha blockers to patients with kidney stones." Because many suppliers understand kidney stones through urologists (such as Hollingsworth) or primary care physicians, treatment guidelines are especially important, he said. "There are a lot of ambiguities behind the British trial. However, our findings help to consolidate the surrounding guidelines for the use of alpha blockers in patients with kidney stones," Hollingsworth said. Original search "Alpha blockers more effective for large kidney stones" Source: Noble
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