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Efficacy of phosphodiesterase type 5 inhibitors for the treatment of distal ureteral calculi: A systematic review and meta-analysis
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논문 기본 정보

Type
Academic journal
Author
Carlos Eduardo Montes Cardona (Universidad del Valle) Herney Andrés García-Perdomo (Universidad del Valle)
Journal
The Korean Urology Association Investigative and Clinical Urology Investigative and Clinical Urology Vol.58 No.2 KCI Accredited Journals
Published
2017.1
Pages
82 - 89 (8page)

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Efficacy of phosphodiesterase type 5 inhibitors for the treatment of distal ureteral calculi: A systematic review and meta-analysis
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Purpose: To determine the efficacy of phosphodiesterase type 5 inhibitors (PDE5i) as medical expulsive therapy (MET) for the treatment of distal ureteral calculi. Materials and Methods: A search strategy was conducted in the MEDLINE, CENTRAL, and Embase databases. Searches were also conducted in other databases and unpublished literature. Clinical trials were included without language restrictions. The risk of bias was evaluated with the Cochrane Collaboration's tool. An analysis of random effects due to statistical heterogeneity was conducted. The primary outcome was the expulsion rate of the distal ureteral calculus in 28 days. The secondary outcomes were the time to expulsion, side effects of treatment, and amount (mg) of nonopioid analgesia. The measure of the effect was the risk difference (RD) with a 95% confidence interval (CI). The planned interventions were PDE5i vs. placebo, tadalafil vs. placebo, and tadalafil vs. tamsulosin. Results: Four articles were included in the qualitative and quantitative analysis. Records of 580 patients were found among the four studies. A low risk of bias was shown for the majority of the study items. The calculi expulsion rate had an RD of 0.26 (95% CI, 0.15–0.37) and a less prolonged expulsion as a secondary outcome with a mean difference of -4.39 days (95% CI, -6.69 to -2.09) in favor of PDE5i compared with the placebo. No significant difference was found for these outcomes when comparing tadalafil with tamsulosin. Conclusions: Compared with a placebo, PDE5i could be effective as MET for the treatment of distal ureter calculi.

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Colella J / 2005 / Urolithiasis/nephrolithiasis:what's it all about? / Urol Nurs 25:427~448 google schola Trinchieri A / 2008 / Epidemiology of urolithiasis: an update / Clin Cases Miner Bone Metab 5:101~106 google schola Wooldridge AA / 1999 / Chronic renal failure associated with nephrolithiasis, ureterolithiasis, and renal dysplasia in a 2-year-old quarter horse gelding / Vet Radiol Ultrasound 40:361~364 google schola Miller OF / 1999 / Time to stone passage for observed ureteral calculi: a guide for patient education / J Urol 162(3 Pt 1):688~690 google schola Dellabella M / 2005 / Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi / J Urol 174:167~172 google schola

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