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• W1567323231 abstract "Background: The impact that distal urolithiasis has on patients can be devastating in terms of discomfort, pain, and overall therapy cost. Traditional first-line treatment for ureteral stone less than 5mm has been conservative therapy consisting of watchful waiting with the main focus placed on pain management. Larger stones in the range of 5mm-10mm have a significantly smaller chance of spontaneous stone expulsion with conservative therapy, many times requiring more invasive therapies such as single wave lithotripsy and uteroscopy. Although these invasive procedures are classified as “minimally invasive”, and have advanced considerably in terms of technology and technique over the past 20 years, they still carry with them risks and a high cost to the patient. Over the years, researchers have isolated an abundance of alpha receptors in the distal ureter similar to those in the male prostate. The blockage of these receptors in the presence of benign prostatic hypertrophy, causes relaxation of the prostate thus increasing the ease by which voiding occurs decreasing the intra-luminal pressure. Likewise, the alpha 1 receptors present in the distal ureter have similar implications to that of the prostate in terms of ureteral relaxation, theoretically increasing the possibility for stone expulsion and reducing renal colic caused by the increased peristaltic movement in the presence of a kidney stone. Hypothesis: The administration of the off-label use of tamsulosin with traditional conservative urolithiasis therapy will increase the facilitation in the presence of radiographically proven distal ureteral calculi in adults when compared to traditional conservative therapy. Study Design: Exhaustive search of available medical literature. Methods: An exhaustive literature search was performed using three main search databases: MedlineOvid, CINAL, and PubMed. The search terms: Urolithiasis, tamsulosin, and Randomized Controlled trial were used with a limit to retrieve studies published after 2007. Results: A total of five articles addressing evaluating the use of 0.4mg tamsulosin versus conservative therapy were used during this study. The primary endpoint addressed, was stone expulsion, because of its direct correlation with therapeutic success. Other clinically relevant and important endpoints such as: total time until stone expulsion, pain, and medication side effects were also evaluated in order to appraise the effectiveness of tamsulosin in the presence of distal ureteral stone. Conclusion: All of the articles evaluating the first-line therapy of tamsulosin in the presence of radiographically proven urolithiasis of less than 1 cm in the adult population illustrated a statistically significant increase in stone expulsion in the 0.4 mg tamsulosin daily administration groups versus conservative therapy groups. Additionally, the secondary endpoints addressed in this study: time to expulsion, pain, and side effects of medication administration demonstrated consistent evidence suggesting positive clinical effectiveness with the use of tamsulosin as a first-line therapy. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/162 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license.] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/162 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author(s) of this work have made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author(s) nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author(s) and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student authors attest that this work is completely their original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed." @default.
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• W1567323231 title "Off-label Use Tamsulosin in the Presence of Uncomplicated Radiographically Proven Distal Urolithiasis" @default.
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