Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and ...Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin,silodosin,and tadalafil on stone expulsion rate(SER)and stone expulsion time(SET),as well as their comparative safety,numbers of colic pain episodes,and need for analgesics.Methods:Randomized controlled trials were retrieved by searching PubMed,Scopus,and Web of Science up to November 27,2023.Hand-searching was also conducted in Google Scholar to find additional records.Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones≤10 mm were included.Results:In total,27 studies were identified(six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar).More than half of them(n=15,56%)were conducted in India.The SER significantly improved with silodosin compared with tamsulosin(odds ratio[OR]2.24,p<0.001),whereas the difference in SET was non-significant.Tadalafil achieved a significantly higher SER compared with tamsulosin(OR 1.42,p=0.042)without any difference in SET.Subgroup analysis of 5-and 10-mg doses of tadalafil showed no significant difference in SER or SET.We found no significant difference in need for analgesics(mean difference(MD−53.73,p=0.2)or the mean number of colic episodes(MD−0.42,p=0.060)between tadalafil and tamsulosin.SER or SET was not significantly different between silodosin and tadalafil.Tadalafil plus tamsulosin led to a significantly higher SER(OR 1.87,p<0.001)and SET(MD−2.99,p=0.002)compared with tamsulosin,without any significant difference in adverse effects.Conclusion:Compared with tamsulosin,SER significantly improved with silodosin,tadalafil,and the combination of tadalafil plus tamsulosin.Meanwhile,the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin.It appears that tadalafil and silodosin have similar efficacy in SET and SER.All medical expulsive therapies had comparable safety.展开更多
The aim of this study was to systematically review the evidence on the efficacy and safety of silodosin treatments on lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） from randomi...The aim of this study was to systematically review the evidence on the efficacy and safety of silodosin treatments on lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） from randomized controlled trials. We searched PubMed （1966- December 2011）, Embase （1974-December 2011） and the Cochrane Library Database （2011, Issue 12）. The assessed outcome measures were the change from baseline for the International Prostate Symptom Score （IPSS）, quality of life （QoL） score, peak urine maximum flow rate （Qmax）, QoL related to urinary symptoms and adverse effects. Two authors independently assessed the study quality and extracted data. All data were analysed using RevMan 5.1. The meta-analysis included four randomized controlled trials with a total of 2504 patients. The study durations were each 12 weeks. At the follow-up end points, the pooled results showed that the change from baseline for the silodosin group was significantly higher than the placebo group for the IPSS, QoL score and Qmax（mean difference （MD）=-2.78, P〈O.O0001; MD=-O.42, P--O.O04; MD= 1.17, P〈O.OOOOl,respectively） and patients felt more satisfied with QoL related to urinary symptoms in the silodosin group than the placebo group. Ejaculation disorder was the most commonly reported adverse effect. The pooled results also showed that the silodosin group was superior to the 0.2 mg tamsulosin group with respect to the IPSS and QoL score （IPSS： MD=- 1.14, P=O.02; QoL score： MD=-0.26, P=O.02） and inferior to the 0.2 mg tamsulosin group with respect to Qmax （MD=-0.85, P=O.01）. In contrast, there was no significant difference in the incidence of ejaculation disorder and dizziness between the silodosin and 0.2 mg tamsulosin groups. The current meta-analysis suggested that silodosin is an effective therapy for LUTS in men with BPH and is not inferior to 0.2 mg tamsulosin.展开更多
Background:Benign prostatic hyperplasia(BPH)is one of the most common causes of lower urinary tract symp-toms(LUTS)in older men.Nowadays,there are several plant extracts used for the treatment of LUTS due to BPH.Objec...Background:Benign prostatic hyperplasia(BPH)is one of the most common causes of lower urinary tract symp-toms(LUTS)in older men.Nowadays,there are several plant extracts used for the treatment of LUTS due to BPH.Objective:The aim of this study is to compare the effect of combining silodosin 8 mg with Serenoa repens,Urtica dioica,Cucurbita pepo(Rotaprost 530 mg)compared to silodosin 8 mg and Rotaprost 530 mg alone in patients with LUTS/BPH.Methods:Four hundred five men with symptomatic BPH were recruited for the study from June 2020 to Jan-uary 2021.Three hundred eighty-nine patients were followed up for 6 months.All participants provided writ-ten informed consent.This prospective study included analysis of three treatment groups:Group I patients(n=130)received a combination of silodosin 8 mg and Rotaprost 530 mg(containing a dry extract of Serenoa repens 80 mg,a dry extract of Urtica dioica 150 mg,a dry extract of Cucurbita pepo seeds 200 mg,zinc(in the form of zinc picolinate)0.105 mg,and selenium(as sodium selenite)22.5μg);the group II(n=129)re-ceived silodosin 8 mg alone,and the group III(n=130)received Rotaprost 530 mg alone.Outcomes were measured by changes from baseline in International Prostate Symptom Score(IPPS)total score,PSA value,prostate volume,residual urine after urination,and maximum flow rate.Statistical significance was set at P<0.05.Results:In group I,IPSS,prostate volume,and maximum urinary flow rate(Qmax)improved significantly(P<0.05)compared with groups II and III during follow-up.Prostate volume in group I showed a significant decrease only during 6 months of therapy(P<0.05).No serious adverse effects were registered in the three groups.Conclusion:Combination therapy with silodosin 8 mg significantly reduced LUTS/BPH,Qmax,and prostate volume compared with silodosin 8 mg alone.Rotaprost 530 mg can also reduce PSA by at least 20.6−25.7%after 6-months of treatment.展开更多
文摘Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin,silodosin,and tadalafil on stone expulsion rate(SER)and stone expulsion time(SET),as well as their comparative safety,numbers of colic pain episodes,and need for analgesics.Methods:Randomized controlled trials were retrieved by searching PubMed,Scopus,and Web of Science up to November 27,2023.Hand-searching was also conducted in Google Scholar to find additional records.Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones≤10 mm were included.Results:In total,27 studies were identified(six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar).More than half of them(n=15,56%)were conducted in India.The SER significantly improved with silodosin compared with tamsulosin(odds ratio[OR]2.24,p<0.001),whereas the difference in SET was non-significant.Tadalafil achieved a significantly higher SER compared with tamsulosin(OR 1.42,p=0.042)without any difference in SET.Subgroup analysis of 5-and 10-mg doses of tadalafil showed no significant difference in SER or SET.We found no significant difference in need for analgesics(mean difference(MD−53.73,p=0.2)or the mean number of colic episodes(MD−0.42,p=0.060)between tadalafil and tamsulosin.SER or SET was not significantly different between silodosin and tadalafil.Tadalafil plus tamsulosin led to a significantly higher SER(OR 1.87,p<0.001)and SET(MD−2.99,p=0.002)compared with tamsulosin,without any significant difference in adverse effects.Conclusion:Compared with tamsulosin,SER significantly improved with silodosin,tadalafil,and the combination of tadalafil plus tamsulosin.Meanwhile,the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin.It appears that tadalafil and silodosin have similar efficacy in SET and SER.All medical expulsive therapies had comparable safety.
文摘The aim of this study was to systematically review the evidence on the efficacy and safety of silodosin treatments on lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） from randomized controlled trials. We searched PubMed （1966- December 2011）, Embase （1974-December 2011） and the Cochrane Library Database （2011, Issue 12）. The assessed outcome measures were the change from baseline for the International Prostate Symptom Score （IPSS）, quality of life （QoL） score, peak urine maximum flow rate （Qmax）, QoL related to urinary symptoms and adverse effects. Two authors independently assessed the study quality and extracted data. All data were analysed using RevMan 5.1. The meta-analysis included four randomized controlled trials with a total of 2504 patients. The study durations were each 12 weeks. At the follow-up end points, the pooled results showed that the change from baseline for the silodosin group was significantly higher than the placebo group for the IPSS, QoL score and Qmax（mean difference （MD）=-2.78, P〈O.O0001; MD=-O.42, P--O.O04; MD= 1.17, P〈O.OOOOl,respectively） and patients felt more satisfied with QoL related to urinary symptoms in the silodosin group than the placebo group. Ejaculation disorder was the most commonly reported adverse effect. The pooled results also showed that the silodosin group was superior to the 0.2 mg tamsulosin group with respect to the IPSS and QoL score （IPSS： MD=- 1.14, P=O.02; QoL score： MD=-0.26, P=O.02） and inferior to the 0.2 mg tamsulosin group with respect to Qmax （MD=-0.85, P=O.01）. In contrast, there was no significant difference in the incidence of ejaculation disorder and dizziness between the silodosin and 0.2 mg tamsulosin groups. The current meta-analysis suggested that silodosin is an effective therapy for LUTS in men with BPH and is not inferior to 0.2 mg tamsulosin.
文摘Background:Benign prostatic hyperplasia(BPH)is one of the most common causes of lower urinary tract symp-toms(LUTS)in older men.Nowadays,there are several plant extracts used for the treatment of LUTS due to BPH.Objective:The aim of this study is to compare the effect of combining silodosin 8 mg with Serenoa repens,Urtica dioica,Cucurbita pepo(Rotaprost 530 mg)compared to silodosin 8 mg and Rotaprost 530 mg alone in patients with LUTS/BPH.Methods:Four hundred five men with symptomatic BPH were recruited for the study from June 2020 to Jan-uary 2021.Three hundred eighty-nine patients were followed up for 6 months.All participants provided writ-ten informed consent.This prospective study included analysis of three treatment groups:Group I patients(n=130)received a combination of silodosin 8 mg and Rotaprost 530 mg(containing a dry extract of Serenoa repens 80 mg,a dry extract of Urtica dioica 150 mg,a dry extract of Cucurbita pepo seeds 200 mg,zinc(in the form of zinc picolinate)0.105 mg,and selenium(as sodium selenite)22.5μg);the group II(n=129)re-ceived silodosin 8 mg alone,and the group III(n=130)received Rotaprost 530 mg alone.Outcomes were measured by changes from baseline in International Prostate Symptom Score(IPPS)total score,PSA value,prostate volume,residual urine after urination,and maximum flow rate.Statistical significance was set at P<0.05.Results:In group I,IPSS,prostate volume,and maximum urinary flow rate(Qmax)improved significantly(P<0.05)compared with groups II and III during follow-up.Prostate volume in group I showed a significant decrease only during 6 months of therapy(P<0.05).No serious adverse effects were registered in the three groups.Conclusion:Combination therapy with silodosin 8 mg significantly reduced LUTS/BPH,Qmax,and prostate volume compared with silodosin 8 mg alone.Rotaprost 530 mg can also reduce PSA by at least 20.6−25.7%after 6-months of treatment.
