Why Alfoo?1
Alpha-blockers are used in the management of LUTS due to Benign Prostatic Hyperplasia (BPH). However, they are likely to cause Ejaculatory Dysfunction (EjD).
Alfoo improves Lower Urinary Tract Symptoms (LUTS) due to BPH with minimal effect on the Ejaculatory Function.
1. Van Moorselaar RJ et al. ALF-ONE Study Group. Alfuzosin 10 mg once daily improves sexual function in men with lower urinary tract symptoms and concomitant sexual dysfunction. BJU Int. 2005 Mar;95(4):603-8.
Mode of Action of Alfuzosin
- The smooth muscle tone is regulated by alpha-adrenergic receptors.
- Blockade of these adrenoreceptors results in smooth muscle in the bladder neck and prostate to relax, further resulting in an improvement in urine flow and a reduction in symptoms of LUTS due to BPH.
- Alfuzosin is a selective antagonist of post-synaptic alpha1-adrenoreceptors, which are located in the prostate, bladder base, bladder neck, prostatic capsule, and prostatic urethra.2
- Alfuzosin’s α1-uroselectivity seems to produce less EjD compared to its counterparts that also affect vascular smooth muscle tone.3
2. Mari A et al. Alfuzosin for the medical treatment of benign prostatic hyperplasia and lower urinary tract symptoms: a systematic review of the literature and narrative synthesis. Ther Adv Urol. 2021 Apr 12;13:1756287221993283. 3. Haywood E. L. Yeung, et al: Alfuzosin and Its Effect on Ejaculatory Dysfunction: A Systematic Review. World J Mens Health. 2021 Apr;39(2):186-194.
What are the Side Effects?4
Postural Hypotension with or without symptoms (e.g. dizziness) may develop within a few hours following administration of Alfuzosin. As with all alpha-blockers, there is a potential for syncope.
- IFIS observed during cataract surgery in some patients on or previously treated with alpha-1 blockers.
- The risk of this event with Alfuzosin appears very low.
- Ophthalmic surgeons should be informed in advance of cataract surgery of current or past use of alpha-1-blockers as IFIS may lead to increased procedural complications.
- The Ophthalmologists should be prepared for possible modifications to their surgical technique.
IFIS: Intraoperative Floppy Iris Syndrome
4. Product information Alfuzosin
Safety Advice4
Patients should be warned of the possible occurrence of syncope and should avoid situations where injury could result in syncope. Care should be taken when Alfuzosin is administered to patients with symptomatic Hypotension or patients who have had a hypotensive response to other medications.
Alfuzosin HCl is contraindicated:
- In patients with moderate or severe hepatic insufficiency
- When administered with potent CYP3A4 inhibitors and therefore, should not be used in combination with drugs such as Ketoconazole, Itraconazole and Ritonavir.
- Pregnancy and Lactation
- Known hypersensitivity to Alfuzosin or any other ingredients of the formulation
- History of Orthostatic Hypotension
4. Product information Alfuzosin
Usage4
- Alfuzosin is used for the treatment of symptomatic BPH.
- The recommended dosage is 10 mg Alfuzosin daily to be taken immediately after the same meal each day. The tablets should not be chewed or crushed.
4. Product information Alfuzosin
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Introducing DailyBloom, India's First Integrated IBS Care Solution
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Air quality and Upper Respiratory Tract Infections (URTIs)
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Managing Allergic Rhinitis
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AR symptoms worsen at night, leading to poor sleep and impaired QoL. Nighttime dosing of antiallergic agents can control this. Nasal congestion, inflammation, and airway resistance from AR disrupt sleep and are major contributors to impaired QoL.Managing Allergic Rhinitis
Unraveling the Clinical Traits of Refractory GERD and Their Prevalence in Indian Population
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Act Now: Addressing PPI-Refractory GERDBixibat- the Only Elobixibat Brand in India
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Dual action of Pro-mobility and Pro-Secretory with Elobixibat
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Detecting and Handling Refractory GERD: The Schemas at Work
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Elobixibat is now in India
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GERD Management: Overcoming the Hurdles of PPI Treatment
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clone of Breakthrough drug from Dr.Reddy's with dual action pf Pro-motility & Pro-Secretory action that combats chronic constipation
clone of Breakthrough drug from Dr.Reddy's with dual action pf Pro-motility & Pro-Secretory action that combats chronic constipation
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The Interconnection Between Air Pollutants and URTIs
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Minimize Adverse Events, Maximize Adherence With PEG!
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Pop & Go: The Fast Track to Oral Drug Delivery with Dissolving Tablets
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Clinical Guidance for Optimal Endodontic Management of Traumatized Permanent Teeth
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Odontalgia Odyssey Navigating Dental Pain Management in India
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Challenges and Insights: Understanding the Raise of Dental Caries in India
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Recommendations by American Dental Association (ADA) for Dental Pain Management
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Healing or Hurdling? Tracking Adherence to Post-Extraction Guidelines After Surgery
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Endodontic Pain Relief: Navigating the Behavioural, Pharmacological, and Anaesthetic Triad
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Emerging Paradigms in Dentistry: Synergies of AI and Nanotechnology in Caries Management
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Essential Potty Chart Guide For Parents!
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Guide to parents getting ready for potty trainingEmpower Parents: Simple Guide To Potty Training
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Join Forces With Parents: Potty Training Success!
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Empower Parents with These Expert Potty Training Tips!Join Forces With Parents: Potty Training Success!
Priority: Impact of rHuEPO on CKD Anemia Care
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Transform Dialysis: Tailored Care or One Approach?
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Why Digital Healthcare Marketing is Essential? Learn from Our Expert Digital Marketers!
Why Digital Healthcare Marketing is Essential? Learn from Our Expert Digital Marketers!
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Transform Your Healthcare Practice with a Strong Online Presence
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Gastric Acid Suppression and The Unmet Needs of PPIs
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HoLEP: Boosting BPH Treatment Success!
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The Clinical Effectiveness of Vonoprazan for Gastric Acid complications
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Discerning the MOA of Vonoprazan in Gastric Acid Management
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Identifying the mode of action of vonoprazan for digestive acid control. Explore the clinical intricacies of vonoprazan in managing gastric acid.Discerning the MOA of Vonoprazan in Gastric Acid Management
Unlocking Hidden Struggles: Neurogenic LUT Dysfunction
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Neuro urological disorders present a multifaceted pathology.Unlocking Hidden Struggles: Neurogenic LUT Dysfunction
Pediatric Cough Management: A Comprehensive Yardstick
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Chronic cough in children, lasting over four weeks, critically impacts quality of life and demands precise diagnosis and treatment. Despite targeted therapies, gaps remain, especially for acute viral cases. Urgent research and tailored guidelines are essential to advance care and improve outcomes.Pediatric Cough Management: A Comprehensive Yardstick
Diagnosis and Management of Chronic Cough in Pediatric Patients
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This article provides expert guidelines for managing chronic cough in children under 14, emphasizing a pediatric-focused approach. It outlines essential diagnostic steps, such as chest radiographs and spirometry, and highlights the need for personalized care and TB screening in high-risk areas.Diagnosis and Management of Chronic Cough in Pediatric Patients
X-ray patterns and insights for different cough categories
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Analyzing X-rays across various categories of cough patients, such as smokers' cough, bronchospastic cough (Asthma), infectious cough (Pneumonia), and postnasal drip cough—offers valuable insights into each condition.X-ray patterns and insights for different cough categories
The impact of long-lasting coughs on diverse patient population
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Chronic coughs worsen health for those with diabetes, GERD, asthma, COPD, heart issues, allergies, & the elderly. They disrupt blood sugar, increase reflux, trigger asthma attacks, obstruct breathing, stress the heart, & heighten allergy sensitivity.The impact of long-lasting coughs on diverse patient population
Impact of untreated long-lasting cough in patients
Impact of untreated long-lasting cough in patients
Chronic cough affects more women than men and can lead to fatigue, sleep disturbances, musculoskeletal pain & psychological issues like anxiety. It may worsen asthma or GERD. Severe coughing episodes can cause rib fractures and urinary incontinence.Impact of untreated long-lasting cough in patients
Decode the 8 week long lasting cough!
Decode the 8 week long lasting cough!
Identifying patients with chronic cough involves assessing symptoms, past infections, smoking history, medication use, and environmental exposure. Common red flags include coughing up blood, shortness of breath, and conditions like asthma or GERD.Decode the 8 week long lasting cough!
Ozone Therapy and pH-Sensitive Nanocarriers in Modern Dentistry
Ozone Therapy and pH-Sensitive Nanocarriers in Modern Dentistry
Discover transformative dental innovations: Ozone therapy offers pain-free caries treatment by eliminating bacteria and aiding remineralization. pH-responsive nanocarriers ensure precise drug delivery, enhancing outcomes and patient comfort. Embrace the future of dentistry with this read!Ozone Therapy and pH-Sensitive Nanocarriers in Modern Dentistry
Modern Restorative Dentistry
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Revolutionize restorative dentistry with advanced nanocomposites and smart technology. This article explores innovations that deliver superior strength, minimal shrinkage, and adaptive properties, enhancing both durability and oral health with precision.Modern Restorative Dentistry
Nanotechnology advancements in dental therapeutics
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Dive into the future of dental care with nanotechnology! This article explores how organic liposomes and hydrogels, along with silver and zinc nanoparticles, provide targeted, precise treatments to fortify enamel and combat decay, revolutionizing caries prevention and tooth repair.Nanotechnology advancements in dental therapeutics
Advancing Regenerative Dentistry
Advancing Regenerative Dentistry
Explore the forefront of dentistry with advancements in regenerative medicine and AI. Delve into the transformative impact of stem cell technologies, 3D bioprinting, and AI-enhanced diagnostics and prosthetic design, driving precision and innovation in dental care.Advancing Regenerative Dentistry
Potty Training Pitfalls: What to Avoid
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What to avoid while potty training your kidsSuccessful Toilet Training: A Step-by-Step Guide
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Step-by-step guide for toilet trainingPEG 3350 Offers an Edge Over Lactulose in The Management of Functional Constipation
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Inadequate Constipation Treatment Turns Simple Discomfort Into A Daily Battle
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Effects of inadequate treatment of functional constipationInadequate Constipation Treatment Turns Simple Discomfort Into A Daily Battle
Unlocking the Path to Pediatric Constipation Relief: Guideline-Backed Insights
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Complete and Long Lasting Symptomatic Relief of Functional Constipation Is the Need of the Hour
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PEG 3350 Long-term Therapy:To Achieve Functional Constipation Treatment Goals
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Darbepoetin Alfa: Convenient Solution For Managing Anemia!
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Cresp the world's firts biosimilar darbepoetin alfa,others improved, conveient, and affordable treatment for anemiaDarbepoetin Alfa: Convenient Solution For Managing Anemia!
Exploring Darbepoetin Alfa Potential Versus Epoetin Beta
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Cresp®, the world's first biosimilar darbepoetin alfa, offers improved, convenient, and affordable treatment for anemia
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Reliable Effectiveness of Darbepoetin Alfa Throughout Dialysis Treatment
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Frequent Use of ESA Triggers Variability in Hemoglobin Levels
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Monthly Darbepoetin Alfa: A Preferred Choice Among CKD Patients
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Dosing Darbepoetin Alfa: Impact on Dialysis Patients
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Revolutionizing Pediatric Constipation Care for Long-Term Relief With PEG
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Uncovering the benefits of using PEG compared to lactulose for long-term relief in children with functional constipation. Pave the Way to Pain-Free Defecation With PEG Does Your Laxative of Choice Stand the Test of Time? Opt for Long-Term EfficacyRevolutionizing Pediatric Constipation Care for Long-Term Relief With PEG
Navigating Functional Constipation: A collaboration Between Parents and Pediatricians
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Childhood Constipation Poses Notable Challenges for Children and Their Families
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High Dose, Zero Hassle: Achieve Effortless Disimpaction With PEG
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PEG-based laxatives offer the convenience of using a high dose for disimpaction without the risk of side effects associated with lactulose.High Dose, Zero Hassle: Achieve Effortless Disimpaction With PEG
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Childhood Constipation Poses Notable Challenges for Children and Their Families
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Exploring the Merits of Darbepoetin Utilization in the Elderly: A Boon or a Bane
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Dosing darbeportin alfa impact on individuals undergoing analysisDosing Darbepoetin Alfa: Impact on Individuals Undergoing Dialysis
Unleash Swift Relief: PEG's Game-Changing Potential
Darbepoetin Alfa: Convenient Solution For Managing Anemia!
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What Sets Polyethylene Glycol Apart in Winning Patient Acceptance
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Chronic constipation is a surprisingly prevalent concern with far-reaching consequences.What Sets Polyethylene Glycol Apart in Winning Patient Acceptance
Individualizing Hb targets in dialysis patients with anemia
Individualizing Hb targets in dialysis patients with anemia
A condition characterized by decreased levels of red blood cells, and is a complex health issue.Individualizing Hb targets in dialysis patients with anemia
Review of Evidence of 24-Hour Blood Pressure Regulation by Amlodipine
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Hypertension acts as the leading factor contributing to the increasing rates of mortality and disability linked to cardiovascular diseases.Review of Evidence of 24-Hour Blood Pressure Regulation by Amlodipine
Treatment Options for Effective Diabetes Management
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Right treatment options and lifestyle changes, managing Diabetes7 Proven Lifestyle Strategies to Prevent Diabetes for a Healthier Future
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Efficacy of α-blocker or 5α-reductase inhibitor withdrawal to continued combination therapy in the management of LUTS with BPH
Efficacy of α-blocker or 5α-reductase inhibitor withdrawal to continued combination therapy in the management of LUTS with BPH
According to a recent study, in men with benign prostatic hyperplasia (BPH)/ lower urinary tract symptoms (LUTS) who are unwilling to continue combination therapy, they may be presented with either α1-adrenergic receptor blocker (AB) or 5α-reductase inhibitor (5ARI) withdrawal if there is a minimum improvement of seven points in International Prostate Symptom Score-total (IPSS-T) and a reduction of at least 20% in prostate volume (PV). This research findings were published in the journal, The Prostate.
This randomized trial included 222 patients with BPH/LUTS who experienced a minimum seven-point improvement[S.1] in IPSS-T and a ≥ 20% decrease in PV after commencing combination therapy. Patients were randomly assigned to continued-combination, AB-withdrawal, and 5ARI-withdrawal groups in a 1:1:1 ratio. Various parameters such as IPSS, EuroQol-five-dimensional questionnaire (EQ-5D-5L), overactive bladder symptom score, EuroQol-visual analog scale (EQ-VAS), PV, postvoid residual urine (PVR), maximal flow rate, and prostate-specific antigen level were assessed every 6 months over a 24-month period and the predictors of IPSS-T deterioration were evaluated.
At month 24, 27.8% of patients in the AB-withdrawal group and 26.4% in the 5ARI-withdrawal group experienced a deterioration of ≥2 points in IPSS-T. Among the patients, 5.6% and 5.7% necessitated the reintroduction of the previously withdrawn medication. EQ-VAS showed improvement in the continued combination group at month 24 compared to baseline (p = 0.028). The AB-withdrawal group displayed enhancements in EQ-VAS, EQ-5D-5L, and PVR at month 24 (all p < 0.005), while the 5ARI-withdrawal group demonstrated improvement in IPSS-S (p = 0.011). Diabetes was associated with a decrease in IPSS-T at the 24-month mark (p = 0.020)
Therefore, for men diagnosed with BPH experiencing LUTS who are unwilling to continue combination therapy may be offered the choice of either discontinuing AB or 5ARI treatment. This option is available if there is a minimum improvement of seven points in the IPSS-T and a reduction of at least 20% in PV.
Efficacy of α-blocker or 5α-reductase inhibitor withdrawal to continued combination therapy in the management of LUTS with BPH
Efficacy of α-blocker or 5α-reductase inhibitor withdrawal to continued combination therapy in the management of LUTS with BPH
According to a recent study, in men with benign prostatic hyperplasia (BPH)/ lower urinary tract symptoms (LUTS) who are unwilling to continue combination therapy, they may be presented with either α1-adrenergic receptor blocker (AB) or 5α-reductase inhibitor (5ARI) withdrawal if there is a minimum improvement of seven points in International Prostate Symptom Score-total (IPSS-T) and a reduction of at least 20% in prostate volume (PV). This research findings were published in the journal, The Prostate.
This randomized trial included 222 patients with BPH/LUTS who experienced a minimum seven-point improvement[S.1] in IPSS-T and a ≥ 20% decrease in PV after commencing combination therapy. Patients were randomly assigned to continued-combination, AB-withdrawal, and 5ARI-withdrawal groups in a 1:1:1 ratio. Various parameters such as IPSS, EuroQol-five-dimensional questionnaire (EQ-5D-5L), overactive bladder symptom score, EuroQol-visual analog scale (EQ-VAS), PV, postvoid residual urine (PVR), maximal flow rate, and prostate-specific antigen level were assessed every 6 months over a 24-month period and the predictors of IPSS-T deterioration were evaluated.
At month 24, 27.8% of patients in the AB-withdrawal group and 26.4% in the 5ARI-withdrawal group experienced a deterioration of ≥2 points in IPSS-T. Among the patients, 5.6% and 5.7% necessitated the reintroduction of the previously withdrawn medication. EQ-VAS showed improvement in the continued combination group at month 24 compared to baseline (p = 0.028). The AB-withdrawal group displayed enhancements in EQ-VAS, EQ-5D-5L, and PVR at month 24 (all p < 0.005), while the 5ARI-withdrawal group demonstrated improvement in IPSS-S (p = 0.011). Diabetes was associated with a decrease in IPSS-T at the 24-month mark (p = 0.020)
Therefore, for men diagnosed with BPH experiencing LUTS who are unwilling to continue combination therapy may be offered the choice of either discontinuing AB or 5ARI treatment. This option is available if there is a minimum improvement of seven points in the IPSS-T and a reduction of at least 20% in PV.
Safety and efficacy of either mirabegron, silodosin, or both in the expulsion of distal ureteric stones
Safety and efficacy of either mirabegron, silodosin, or both in the expulsion of distal ureteric stones
A recent study demonstrated that lower ureteric stones can be effectively treated with both silodosin and mirabegron. Furthermore, when these medications are used together, they have been found to increase the rate of stone expulsion and reduce the duration of expulsion. This study’s findings were published in the journal, International Urology and Nephrology.
This study included 105 patients, aged 20 to 56 years, who were diagnosed with a single radiopaque distal ureteral stone measuring ≤ 10 mm. The individuals were randomly allocated into three groups, each group containing 35 participants. Group A received an 8 mg daily dose of silodosin, group B was given 50 mg of mirabegron once daily, and group C received a combination of both medications. Treatment was given until the stone passed or for a maximum of four weeks. The stone-free rate was assessed by analyzing KUB films with or without ultrasonography.
Stone expulsion rate was higher in group C in comparison to groups A and B. The mean (standard deviation) time for expulsion of the stone in group A, group B, and group C was 14 ± 2.3 days, 11 ± 3.1 days, and 7 ± 2.2 days, respectively. Group C exhibited a significantly shorter stone expulsion time when compared to groups A and B. The incidence of renal colic in group C was significantly lower than that in groups A and B, leading to a decreased need for analgesics. Anejaculation was significantly more frequent in the silodosin group (73.9%) and combination group (84%) than in the mirabegron group.
Thus, it can be concluded that both silodosin and mirabegron are effective treatments for lower ureteric stones. Additionally, when these medications are utilized in combination, they have been shown to increase the rate of stone expulsion and decrease the duration of expulsion.
Safety and efficacy of either mirabegron, silodosin, or both in the expulsion of distal ureteric stones
Safety and efficacy of either mirabegron, silodosin, or both in the expulsion of distal ureteric stones
A recent study demonstrated that lower ureteric stones can be effectively treated with both silodosin and mirabegron. Furthermore, when these medications are used together, they have been found to increase the rate of stone expulsion and reduce the duration of expulsion. This study’s findings were published in the journal, International Urology and Nephrology.
This study included 105 patients, aged 20 to 56 years, who were diagnosed with a single radiopaque distal ureteral stone measuring ≤ 10 mm. The individuals were randomly allocated into three groups, each group containing 35 participants. Group A received an 8 mg daily dose of silodosin, group B was given 50 mg of mirabegron once daily, and group C received a combination of both medications. Treatment was given until the stone passed or for a maximum of four weeks. The stone-free rate was assessed by analyzing KUB films with or without ultrasonography.
Stone expulsion rate was higher in group C in comparison to groups A and B. The mean (standard deviation) time for expulsion of the stone in group A, group B, and group C was 14 ± 2.3 days, 11 ± 3.1 days, and 7 ± 2.2 days, respectively. Group C exhibited a significantly shorter stone expulsion time when compared to groups A and B. The incidence of renal colic in group C was significantly lower than that in groups A and B, leading to a decreased need for analgesics. Anejaculation was significantly more frequent in the silodosin group (73.9%) and combination group (84%) than in the mirabegron group.
Thus, it can be concluded that both silodosin and mirabegron are effective treatments for lower ureteric stones. Additionally, when these medications are utilized in combination, they have been shown to increase the rate of stone expulsion and decrease the duration of expulsion.
Impact of focal zone size on treatment outcomes and renal injury subsequent to extracorporeal shockwave lithotripsy for renal calculi
Impact of focal zone size on treatment outcomes and renal injury subsequent to extracorporeal shockwave lithotripsy for renal calculi
A recent study showed that the standard narrow focal zone (FZ) demonstrates similar safety and superior treatment efficacy when compared to the extended FZ during extracorporeal shockwave lithotripsy (SWL) for renal stones. This study’s findings were published in Journal of Endourology.
In this prospective randomized study, 276 patients diagnosed with renal stones were assigned to receive SWL using either standard or extended FZ. The treatment was administered using a Modulith SLX-F2 lithotripter, delivering a maximum of 3000 shocks at a frequency of 1.5 Hz. The primary outcome of the study assessed the success of the treatment 12 weeks after a single SWL session, which was determined by the absence of a stone or stone fragment smaller than 4 mm on computed tomography. Secondary outcomes included the incidence of the stone-free rate (SFR), perinephric hematoma, and changes in the levels of acute renal injury markers in the urine.
Similar baseline parameters were observed in both groups. The standard FZ group achieved a significantly higher treatment success rate (74.3%) than the extended FZ group (59.3%). Additionally, standard FZ exhibited a significantly better SFR (Grade-A, 36.8% vs. 23.0%,) and lower post-treatment pain levels. Both groups had comparable rates of perinephric hematoma formation, changes in urinary acute renal injury markers, and unplanned hospital admissions.
The above results demonstrated that the standard narrow FZ shows comparable safety and improved treatment efficacy in comparison to the extended FZ in extracorporeal SWL for renal stones.
Impact of focal zone size on treatment outcomes and renal injury subsequent to extracorporeal shockwave lithotripsy for renal calculi
Impact of focal zone size on treatment outcomes and renal injury subsequent to extracorporeal shockwave lithotripsy for renal calculi
A recent study showed that the standard narrow focal zone (FZ) demonstrates similar safety and superior treatment efficacy when compared to the extended FZ during extracorporeal shockwave lithotripsy (SWL) for renal stones. This study’s findings were published in Journal of Endourology.
In this prospective randomized study, 276 patients diagnosed with renal stones were assigned to receive SWL using either standard or extended FZ. The treatment was administered using a Modulith SLX-F2 lithotripter, delivering a maximum of 3000 shocks at a frequency of 1.5 Hz. The primary outcome of the study assessed the success of the treatment 12 weeks after a single SWL session, which was determined by the absence of a stone or stone fragment smaller than 4 mm on computed tomography. Secondary outcomes included the incidence of the stone-free rate (SFR), perinephric hematoma, and changes in the levels of acute renal injury markers in the urine.
Similar baseline parameters were observed in both groups. The standard FZ group achieved a significantly higher treatment success rate (74.3%) than the extended FZ group (59.3%). Additionally, standard FZ exhibited a significantly better SFR (Grade-A, 36.8% vs. 23.0%,) and lower post-treatment pain levels. Both groups had comparable rates of perinephric hematoma formation, changes in urinary acute renal injury markers, and unplanned hospital admissions.
The above results demonstrated that the standard narrow FZ shows comparable safety and improved treatment efficacy in comparison to the extended FZ in extracorporeal SWL for renal stones.
Combination of co-trimoxazole and NAC effective in reducing bacterial adherence on ureteral stent surfaces
Combination of co-trimoxazole and NAC effective in reducing bacterial adherence on ureteral stent surfaces
According to a recent study, a combination of co-trimoxazole and N-acetylcysteine (NAC) is more effective in reducing bacterial adherence on ureteral stent surfaces than either alone. This study was published in the journal, Urolithiasis.
This prospective randomized study included 636 patients, who underwent double J ureteral stent insertion after various urological procedures. Patients were randomized into four groups: no antibiotics or mucolytics during stent indwelling in group A (n = 165); oral NAC (200 mg/day for children aged < 12 years old and 600 mg/day for adults) during stent indwelling in group B (n = 153), oral co-trimoxazole (2 mg TMP/kg/day) during stent indwelling in group C (n = 162), and both oral NAC and co-trimoxazole during stent indwelling in group D (n = 156).
After a duration of two weeks from the insertion of the double J stent (JJ stent), a urinalysis was conducted on all patients and on the day of double J stent removal, a urine culture was carried out for all the patients. 2-weeks postoperatively, the stent was removed, and a stent segment sized 3-5 cm from the bladder segment of the stent was sent for culture. It was found that 63.6%, 43.1%, 37%, and 19.2% patients of groups A, B, C, and D, respectively had positive stent cultures. The most commonly isolated organism from the stent culture in all groups was E. coli.
The above findings suggest that the combination of co-trimoxazole and NAC is more effective in reducing bacterial adherence on ureteral stent surfaces than either alone.
Combination of co-trimoxazole and NAC effective in reducing bacterial adherence on ureteral stent surfaces
Combination of co-trimoxazole and NAC effective in reducing bacterial adherence on ureteral stent surfaces
According to a recent study, a combination of co-trimoxazole and N-acetylcysteine (NAC) is more effective in reducing bacterial adherence on ureteral stent surfaces than either alone. This study was published in the journal, Urolithiasis.
This prospective randomized study included 636 patients, who underwent double J ureteral stent insertion after various urological procedures. Patients were randomized into four groups: no antibiotics or mucolytics during stent indwelling in group A (n = 165); oral NAC (200 mg/day for children aged < 12 years old and 600 mg/day for adults) during stent indwelling in group B (n = 153), oral co-trimoxazole (2 mg TMP/kg/day) during stent indwelling in group C (n = 162), and both oral NAC and co-trimoxazole during stent indwelling in group D (n = 156).
After a duration of two weeks from the insertion of the double J stent (JJ stent), a urinalysis was conducted on all patients and on the day of double J stent removal, a urine culture was carried out for all the patients. 2-weeks postoperatively, the stent was removed, and a stent segment sized 3-5 cm from the bladder segment of the stent was sent for culture. It was found that 63.6%, 43.1%, 37%, and 19.2% patients of groups A, B, C, and D, respectively had positive stent cultures. The most commonly isolated organism from the stent culture in all groups was E. coli.
The above findings suggest that the combination of co-trimoxazole and NAC is more effective in reducing bacterial adherence on ureteral stent surfaces than either alone.
Effectiveness of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi
Effectiveness of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi
A recent study suggests the use of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) led to an increased stone-free rate (SFR) in cases of staghorn calculi, necessitated fewer percutaneous tracts, decreased the necessity for staged surgery, and resulted in a shorter operative duration compared to single percutaneous nephrolithotomy (sPNL ). The study findings were published in the journal, Urolithiasis.
A total of 160 patients were included in this prospective randomized controlled study, with 81 patients in the sPNL group and 79 patients in the aPNL group. Initially, the study focused on comparing the overall differences between sPNL and aPNL. Subsequently, the patients were categorized into two subgroups: Group 1 (patients with < 5 stone branches) and Group 2 (patients with ≥ 5 stone branches). The differences between these two subgroups were analyzed.
The study results revealed that aPNL exhibited a higher SFR and required fewer percutaneous tracts, with a shorter operation time compared to sPNL. Additionally, aPNL reduced the need for staged surgery, especially in patients with ≥ 5 stone branches. There were no significant variances in hemoglobin level changes and the requirement for blood transfusions between the sPNL and aPNL groups, and the frequency of multiple tracts was lower in the aPNL group.
Thus, it can be concluded that aPNL led to an increased SFR in staghorn calculi, necessitated fewer percutaneous tracts, minimized the requirement for staged surgery, and had a shorter operative duration compared to PNL alone. This was particularly notable in patients with ≥ 5 stone branches.
Effectiveness of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi
Effectiveness of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi
A recent study suggests the use of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) led to an increased stone-free rate (SFR) in cases of staghorn calculi, necessitated fewer percutaneous tracts, decreased the necessity for staged surgery, and resulted in a shorter operative duration compared to single percutaneous nephrolithotomy (sPNL ). The study findings were published in the journal, Urolithiasis.
A total of 160 patients were included in this prospective randomized controlled study, with 81 patients in the sPNL group and 79 patients in the aPNL group. Initially, the study focused on comparing the overall differences between sPNL and aPNL. Subsequently, the patients were categorized into two subgroups: Group 1 (patients with < 5 stone branches) and Group 2 (patients with ≥ 5 stone branches). The differences between these two subgroups were analyzed.
The study results revealed that aPNL exhibited a higher SFR and required fewer percutaneous tracts, with a shorter operation time compared to sPNL. Additionally, aPNL reduced the need for staged surgery, especially in patients with ≥ 5 stone branches. There were no significant variances in hemoglobin level changes and the requirement for blood transfusions between the sPNL and aPNL groups, and the frequency of multiple tracts was lower in the aPNL group.
Thus, it can be concluded that aPNL led to an increased SFR in staghorn calculi, necessitated fewer percutaneous tracts, minimized the requirement for staged surgery, and had a shorter operative duration compared to PNL alone. This was particularly notable in patients with ≥ 5 stone branches.
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