Kasimov S.S (1), Rahmonberdiyev Kh.K (2), Abdusatarov A.U (3)
The results of a study evaluating the effectiveness of α1-blockers in the comprehensive treatment of ureteral stones are presented. A prospective, comparative, single-center study included 118 patients diagnosed with a single stone in various parts of the ureter. Following pain management, all patients underwent conservative treatment aimed at promoting spontaneous stone passage. The maximum duration of conservative therapy was 30 days, with weekly ultrasound monitoring conducted for all patients. In the control group, patients received only drotaverine 40 mg three times a day along with analgesics. In the main group, patients received drotaverine and analgesics, as well as the α1-adrenergic blocker tamsulosin at a standard dose of 0.4 mg once daily. The likelihood of stone passage in the distal ureter was significantly higher (p = 0.02) in the group receiving α1-blockers. Furthermore, patients in the main group experienced better pain control throughout the observation period, even if no stones passed. The probability of stone migration from the proximal to the distal ureter was 52% in the main group compared to 32% in the control group (p = 0.17). Adverse effects were similar in both groups, though dizziness, postural hypotension, and weakness were notably more frequent in the main group.Univariate and multivariate analysis using the proportional hazards model showed that the addition of α1-blockers to the treatment regimen significantly increased the likelihood of stone passage from the distal ureter. It was also found that the type of therapy used directly impacted the risk of earlier stone passage. The inclusion of α1-blockers in the treatment plan increased the chances of stone passage by a factor of 4.11.
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