比較甲型阻斷劑Tamsulosin，Silodosin和Tadalafil
對於遠端輸尿管結石的結石排除率：統合分析及系統性文獻回顧
黃品叡、陳丕哲、沈正煌、林昌德、鄭明進
戴德森醫療財團法人嘉義基督教醫院 外科部 泌尿科
Comparison of expulsive rate of distal ureteral stone between Tamsulosin, Silodosin, and Tadalafil : A Meta-Analysis and Systematic Review
Pin-Jui Huang, Pi-Che Chen, Cheng-Huang Shen, Chang-Te Lin, Ming-Chin Cheng
Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
Introduction： Ureteral calculi is a common disease in urology. Medical expulsive therapy was world widely used for distal ureteral stone. Such as Tamsulosin, Silodosin, and Tadalafil are drugs for the drug expulsion method for treating distal ureteral calculi . This article hopes to compare the stone clearance rate of Tamsulosin, Silodosin and Tadalafil for distal ureteral stones through empirical methods , as a consideration for clinical treatment options.
Material and Method:
A comprehensive database search including Pubmed, Cochrane library, and Airiti Library was performed for retrospective studies till Octobor 2022 that assessed Tamsulosin, Silodosin, Tadalafil and distal ureteral stone. Studies without data of medical expulsive therapy were excluded. The primary outcome was stone free rate. Pooled relative risk or hazard ratio with 95 percent confidence intervals were calculated for each outcome. The analytic process was generated with the meta-analysis software Review Manager (version 5.4 ).
Results:
Five studies with a total 652 patients were identified for qualitative synthesis. Group I (Tamsulosin versus Silodosin) showed better stone free rate in Tamsulosin arm (Risk ratio 0.83, 95% c.i. 0.71 to 0.97), p = 0.02, I2 = 45%). Group II (Tadalafil versus Tamsulosin) showed better stone free rate in Tadalafil arm (Risk ratio 0.85, 95% c.i. 0.75 to 0.97), p = 0.02, I2 = 45%). Group III (Tamsulosin versus Tadalafil) showed better stone free rate in Tamsulosin arm (Risk ratio 0.95, 95% c.i. 0.81 to 1.12, I2 = 47%), but the result was without statistically significance (p = 0.57).
Conclusions: