Hollingsworth: Our review helps solidify the current guidelines, which recommend off-label use of alpha blockers, such as tamsulosin, known as Flomax, for kidney stones. What should providers take away from this? In addition to a shorter time to pass the stone, patients who used alpha blockers also reported fewer pain episodes and a lower risk of hospital admission, and they were less likely to undergo surgery. The location of the stone did not make a difference, nor did the type of alpha blocker used. However, the benefit was not there for smaller stones. We reported a 57 percent higher risk of stone passage for larger stones when the patient was taking an alpha blocker. SEE ALSO: A Step Toward a Vaccine Against Urinary Tract Infections Hollingsworth: Overall, the results show moderate evidence to support using alpha blockers for those kidney stone patients who do not require urgent surgery. We also considered stone size and location to see if either one was a factor in successfully passing the stone.
ALPHA BLOCKERS FULL
With this approach, we were able to evaluate 5,990 subjects all at once and get a full picture of the situation. Our team pooled together 55 randomized controlled trials, all comparing alpha blockers to placebo or control. So we thought it was important to take those findings and put them into the context of what is already known about kidney stones. There had been a fair amount of ambiguity following the U.K. compared alpha blockers to placebo in 1,136 subjects and did not find the alpha blockers effective. Hollingsworth: The popular recent article suggested it may not be worth the time or money to try alpha blockers for kidney stone patients. What was different about your research approach? He explains more about the significance of the work, published this month in The BMJ. “It’s a win for our patients to have nonsurgical help to pass their kidney stones.” “We found alpha blockers do work for larger kidney stones,” Hollingsworth says. The review suggests physicians should feel confident following current guidelines. John Hollingsworth, M.D., associate professor of urology at the University of Michigan Medical School, served as first author on a new review of 55 pieces of kidney stone research that investigated the effect of alpha blockers. MORE FROM THE LAB: Subscribe to our weekly newsletterįor patients with kidney stones that won’t pass on their own, contemporary practice guidelines recommend considering alpha blockers to facilitate stone passage.īut when a 2015 study questioned the effectiveness of alpha blockers for this purpose, many physicians wondered whether to change course.
Providers are always looking for the right combination of lowest risk and highest benefit for their patients.
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