Improved stone quality of life in patients with an obstructing ureteral stone on alpha-blocker medical expulsive therapy

Susan Talamini, Daniel Wong, Tarik Phillips, Joshua Palka, Joel Vetter, Alexander Chow, Alethea Paradis, Alana Desai, Kenneth Sands, Charles Nottingham, Ramakrishna Venkatesh

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Though controversial, alpha blockers are used widely for ureteral stone passage. However, its effects on the patient-reported Quality of life (QOL) is unknown. We compared the QoL of patients on alpha-blocker medical expulsive therapy (MET) to patients not on MET (noMET) utilizing the validated Wisconsin Stone Quality of Life (WISQOL). Methods: This prospective study included patients prescribed either MET or noMET after presentation with symptomatic, obstructing ureteral stones. The treatment arm was decided at the point of care by the initial treating physician and included analgesia and antiemetics. Tamsulosin (0.4 mg daily) was prescribed for the MET group. The WISQOL survey was administered at baseline, 7-, 14-, 21- and 28-days following discharge from the ED or until stone expulsion. Results: 197 patients were enrolled, of which 116 (59.2%) completed questionnaires for analysis, 91 in the MET group and 25 in noMET. Average ureteral stone size was 4.7 mm (SD 1.8) and 3.1 mm (SD 1.0) for MET and noMET, respectively. Of completed surveys, 105 (90%) were completed at day 7, 67 (57.6%) at day 14, 53 (45.7%) at day 21, and 40 (34.5%) at day 28. MET was associated with improved QoL scores across all WISQOL domains compared to noMET. Stone size, age, race, sex, comorbidity score and a prior stone history were not associated with reduced QoL. Conclusions: The use of MET was associated with improved QOL on all WISQOL metrics compared to noMET patients. Improved stone QOL may be an indication of alpha-blocker therapy in patients with ureteral stone colic.

Original languageEnglish
Pages (from-to)1289-1295
Number of pages7
JournalInternational Urology and Nephrology
Volume56
Issue number4
DOIs
StatePublished - Apr 2024

Keywords

  • Endourology
  • Medical expulsive therapy
  • Nephrolithiasis
  • Quality of Life

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