The use of alpha-blockers for the treatment of nephrolithiasis

Abstract

Medical expulsion therapy has been shown to be a useful adjunct to observation in the management of ureteral stones. Alpha-1-adrenergic receptor antagonists have been studied in this role. Alpha-1 receptors are located in the human ureter, especially the distal ureter. Alpha-blockers have been demonstrated to increase expulsion rates of distal ureteral stones, decrease time to expulsion, and decrease need for analgesia during stone passage. Alpha-blockers promote stone passage in patients receiving shock wave lithotripsy, and may be able to relieve ureteral stent-related symptoms. In the appropriate clinical scenario, the use of alpha-blockers is recommended in the conservative management of distal ureteral stones.

Figures

Figure 1

Representation of the kidney and ureter with density of α receptors as studied by Sigala et al. Alpha-1d receptor is the most common in all segments of the ureter. The highest overall density of α1 receptors is in the distal ureter.