Cochrane · systematic review · CD008509
Alpha‐blockers as medical expulsive therapy for ureteral stones
Campschroer, T, Zhu, X, Vernooij, RWM, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
UrologyAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
14
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 9 · 64.3%Moderate 4 · 28.6%High 1 · 7.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Alpha‐blockers compared with standard therapy for ureteral stones
Population: adult patients presenting with symptoms of ureteral stone disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Stone clearance Alpha‐blockers vs standard therapy | RR 1.45 [1.36, 1.55] | 67 studies · 10509 participants | Low Downgraded: risk of bias |
Major adverse events Alpha‐blockers vs standard therapy | RR 1.25 [0.8, 1.96] | 18 studies · 3124 participants | Low Downgraded: risk of bias |
Stone expulsion time Alpha‐blockers vs standard therapy | no estimate extracted | 37 studies · 6031 participants | Low Downgraded: risk of bias |
Pain episodes Alpha‐blockers vs standard therapy | no estimate extracted | 15 studies · 1363 participants | Low Downgraded: risk of bias |
Dose of diclofenac Alpha‐blockers vs standard therapy | no estimate extracted | 14 studies · 4373 participants | Low Downgraded: risk of bias |
Hospitalisation Alpha‐blockers vs standard therapy | RR 0.51 [0.34, 0.77] | 13 studies · 1876 participants | Moderate Downgraded: risk of bias |
Surgical intervention Alpha‐blockers vs standard therapy | RR 0.74 [0.53, 1.02] | 19 studies · 3292 participants | Low Downgraded: risk of bias |
Alpha‐blockers compared with placebo for ureteral stones
Population: adult patients presenting with symptoms of ureteral stone disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Stone clearance Alpha‐blockers vs placebo | RR 1.16 [1.07, 1.25] | 15 studies · 5787 participants | Moderate Downgraded: inconsistency |
Major adverse events Alpha‐blockers vs placebo | RR 2.09 [1.13, 3.86] | 10 studies · 1650 participants | Moderate Downgraded: imprecision, inconsistency |
Stone expulsion time Alpha‐blockers vs placebo | no estimate extracted | 7 studies · 3240 participants | Low Downgraded: imprecision, inconsistency |
Pain episodes Alpha‐blockers vs placebo | no estimate extracted | 2 studies · 215 participants | Low Downgraded: imprecision, inconsistency |
Dose of diclofenac (mg) Alpha‐blockers vs placebo | no estimate extracted | 4 studies · 3576 participants | Low Downgraded: imprecision, inconsistency |
Hospitalisation Alpha‐blockers vs placebo | RR 0.84 [0.48, 1.47] | 2 studies · 500 participants | Moderate Downgraded: imprecision, inconsistency |
Surgical intervention Alpha‐blockers vs placebo | RR 0.93 [0.7, 1.24] | 5 studies · 1458 participants | High |