Medical expulsive therapy for pediatric ureteral stones: A meta-analysis of randomized clinical trials

Basit Öğe Kaydı
dc.authorid0000-0002-6308-1763
dc.contributor.authorZiaeefar, Pardis
dc.contributor.authorBasiri, Abbas
dc.contributor.authorZangiabadian, Moein
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.contributor.authorZargar, Homayoun
dc.contributor.authorTaheri, Maryam
dc.contributor.authorKashi, Amir H.
dc.date.accessioned2023-03-10T09:55:11Z
dc.date.available2023-03-10T09:55:11Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractTo evaluate the efficacy and safety of medical expulsive therapy (MET) for ureteral stones in pediatric patients, Cochrane, PubMed, Web of Science, Scopus, and the reference list of retrieved studies were searched up to September 2022 to identify RCTs on the efficacy of MET. The protocol was prospectively registered at PROSPERO (CRD42022339093). Articles were reviewed, data were extracted by two reviewers, and the differences were resolved by the third reviewer. The risk of bias was assessed using the RoB2. The outcomes, including the stone expulsion rate (SER), stone expulsion time (SET), episode of pain, analgesic consumption, and adverse effects, were evaluated. Six RCTs enrolling 415 patients were included in the meta-analysis. The duration of MET ranged from 19 to 28 days. The investigated medications included tamsulosin, silodosin, and doxazosin. The stone-free rate after 4 weeks in the MET group was 1.42 times that of the control group (RR: 1.42; 95% CI: 1.26–1.61, p < 0.001). The stone expulsion time also decreased by an average of 5.18 days (95% CI: ?8.46/?1.89, p = 0.002). Adverse effects were more commonly observed in the MET group (RR: 2.18; 95% CI: 1.28–3.69, p = 0.004). The subgroup analysis evaluating the influence of the type of medication, the stone size, and the age of patients failed to reveal any impact of the aforementioned factors on the stone expulsion rate or stone expulsion time. Alpha-blockers as medical expulsive therapy among pediatric patients are efficient and safe. They increase the stone expulsion rate and decrease the stone expulsion time; however, this included a higher rate of adverse effects, which include headache, dizziness, or nasal congestion.
dc.identifier.citationZiaeefar, P., Basiri, A., Zangiabadian, M., de la Rosette, J. J. M. C. H., Zargar, H., Taheri, M. ... Kashi, A. H. (2023). Medical expulsive therapy for pediatric ureteral stones: A meta-analysis of randomized clinical trials. Journal of Clinical Medicine, 12(4). https://dx.doi.org/10.3390/jcm12041410
dc.identifier.doi10.3390/jcm12041410
dc.identifier.issn2077-0383
dc.identifier.issue4
dc.identifier.pmid36835945
dc.identifier.scopus2-s2.0-85148956689
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://dx.doi.org/10.3390/jcm12041410
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10607
dc.identifier.volume12
dc.identifier.wos000938564600001en_US
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorde la Rosette, Jean J. M. C. H.
dc.language.isoen
dc.publisherMDPI
dc.relation.ispartofJournal of Clinical Medicineen_US
dc.relation.publicationcategoryDiğer
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectAdrenergic Alpha-Antagonists
dc.subjectMedical Expulsive Therapy
dc.subjectMeta-Analysis
dc.subjectPediatrics
dc.subjectRandomized Controlled Trial
dc.subjectUreteral Stones
dc.titleMedical expulsive therapy for pediatric ureteral stones: A meta-analysis of randomized clinical trials
dc.typeReview Article

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