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SGEM#4: Getting Un-Stoned (Renal Colic and Alpha Blockers)

Posted by on Sep 16, 2012 in Featured, Genitourinary, Podcasts | 4 comments

Podcast Link:SGEM4 Date: September 6, 2012 Case Scenario: A 49 year old man presents to the ED with his typical problem of renal colic. Question: Is an alpha blocker safe and effective for the treatment of kidney stones? Reference: Vincendeau et al. Tamsulosin Hydrochloride vs Placebo for Management of Distal Ureteral Stones. Arch Intern Med. 2010;170(22):2021­2027 PMID: 21149761 Population: 129 adult patients with acute renal colic presenting to ED with stone size of 2­7mm. Exclusion criteria: Pregnant or breastfeeding women, patients receiving alpha or beta-blockers, those with   transient hypotension, those with liver impairment, and those requiring a surgical procedure because of infection or continuation of pain after medical treatment were excluded. Patients with spontaneous passage before randomization were also excluded. Intervention: Tamsulosin 0.4mg OD Control: Placebo Outcome: Time to stone expulsion from inclusion in study up to 42 days. Authors’ Conclusions: “Although well tolerated, a daily administration of 0.4 mg of tamsulosin did not accelerate the expulsion of distal ureteral stones in patients with ureteral colic” BEEM Commentary: Renal colic is a very common...

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