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Effect of medical expulsive therapy on the health-related quality of life of patients with ureteral stones: a critical evaluation

Abstract

Purpose

To evaluate the possible effects of medical expulsive therapy (MET) on the health-related quality of life (HRQOL) of the patients under watchful waiting for ureteral stones.

Patients and methods

A total 120 patients with ureteral stones were included into this study program. Patients were divided into two subgroups. While patients in group 1 received medical therapy only for colic pain if needed, patients in group 2 received MET (tamsulosin 0.4 mg/once daily) in addition to medical therapy. All cases were evaluated weekly during 1-month period, and the patients with persistent stones after this period in both groups were evaluated with respect to the analgesic requirement, number of renal colic attacks as well as emergency department (ED) visits along with the QOL scores.

Results

Mean values of patient age and stone burden were 37.14 ± 2.46 years and 42.04 ± 2.03 mm2, respectively. Evaluation of the cases with residing stones after 4 weeks (28 cases in group 1 and 27 cases in group 2) with or without MET revealed following findings; renal colic, total amount of analgesic required and the mean number of ED visits were significantly lower in cases receiving MET. Evaluation of the mean HRQOL in terms of EQ-5D index and EQ-5D VAS values in both groups again demonstrated higher mean values in patients undergoing MET (p < 0.05).

Conclusion

Our findings indicated that MET for ureteral calculi during watchful waiting period could increase the HRQOL scores by lowering the number of both renal colic attacks and ED visits resulting in decreased analgesic need.

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References

  1. 1.

    Tiselius HG (2003) Epidemiology and medical management of stone disease. BJU Int 91:758–767

  2. 2.

    Scales CD, Smith AC, Hanley JM, Saigal CS (2012) Prevalence of kidney stones in the United States. Eur Urol 62:160–165

  3. 3.

    Hollingsworth JM, Norton EC, Kaufman SR, Smith RM, Wolf JS Jr, Hollenbeck BK (2013) Medical expulsive therapy versus early endoscopic stone removal for acute renal colic: an instrumental variable analysis. J Urol 190:882–887

  4. 4.

    Coll DM, Varanelli MJ, Smith RC (2002) Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT. Am J Roentgenol 178:101–103

  5. 5.

    Seitz C, Liatsikos E, Porpiglia F, Tiselius HG, Zwergel U (2009) Medical therapy to facilitate the passage of stones: what is the evidence? Eur Urol 56:455–471

  6. 6.

    Pedro RN, Hinck B, Hendlin K, Feia K, Canales BK, Monga M (2008) Alfuzosin stone expulsion therapy for distal ureteral calculi: a double-blind, placebo controlled study. J Urol 179:2244–2247

  7. 7.

    Lee SR, Jeon HG, Park DS, Choi YD (2012) Longitudinal stone diameter on coronal reconstruction of computed tomography as a predictor of ureteral stone expulsion in medical expulsive therapy. Urology 80:784–789

  8. 8.

    Hollingsworth JM, Wolf JS Jr, Faerber GJ, Roberts WW, Dunn RL, Hollenbeck BK (2010) Understanding the barriers to the dissemination of medical expulsive therapy. J Urol 184:2368–2372

  9. 9.

    Resim S, Ekerbicer H, Ciftci A (2005) Effect of tamsulosin on the number and intensity of ureteral colic in patients with lower ureteral calculus. Int J Urol 12:615–620

  10. 10.

    EuroQol Group (2008) EQ-5D available versions. http://www.euroqol.org/web/users/language_a.php

  11. 11.

    Hermanns T, Sauermann P, Rufibach K, Frauenfelder T, Sulser T, Strebel RT (2009) is there a role for tamsulosin in the treatment of distal ureteral stones of 7 mm or less? Results of a randomised, double-blind, placebo-controlled trial. Eur Urol 56:407–412

  12. 12.

    Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck C, Gallucci M et al (2007) Guideline for the management of ureteral calculi. J Urol 178:2418–2434

  13. 13.

    Miller OF, Kane CJ (1999) Time to stone passage for observed ureteral calculi: a guide for patient education. J Urol 162:688–691

  14. 14.

    Lotan Y, Gettman MT, Roehrborn CG, Cadeddu JA, Pearle MS (2002) Management of ureteral calculi: a cost comparison and decision making analysis. J Urol 167:1621–1629

  15. 15.

    Zheng S, Liu LR, Yuan HC, Wei Q (2010) Tamsulosin as adjunctive treatment after shockwave lithotripsy in patients with upper urinary tract stones: a systematic review and meta-analysis. Scand J Urol Nephrol 44:425–432

  16. 16.

    Campschroer T, Zhu Y, Duijvesz D, Grobbee DE, Lock MT (2014) Alpha-blockers as medical expulsive therapy for ureteral stones. Cochrane Database Syst Rev 4:CD008509

  17. 17.

    Penniston KL, Nakada SY (2007) Health related quality of life differs between male and female stone formers. J Urol 178:2435–2440

  18. 18.

    Bensalah K, Tuncel A, Gupta A, Raman JD, Pearle MS, Lotan Y (2008) Determinants of quality of life for patients with kidney stones. J Urol 179:2238–2243

  19. 19.

    Rabah DM, Alomar M, Binsaleh S, Arafa MA (2011) Health related quality of life in ureteral stone patients: post-ureterolithiasis. Urol Res 39:385–388

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Author information

Correspondence to Cahit Sahin.

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The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Eryildirim, B., Sahin, C., Tuncer, M. et al. Effect of medical expulsive therapy on the health-related quality of life of patients with ureteral stones: a critical evaluation. Int Urol Nephrol 47, 1271–1275 (2015). https://doi.org/10.1007/s11255-015-1036-7

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Keywords

  • Ureteral stone
  • MET
  • QoL
  • Alpha-blocker