Doxazosin for the management of distal-ureteral stones

Purpose: To evaluate the efficacy of doxazosin in inducing spontaneous passage of stones in the distal ureter and to compare its efficacy according to the size of the stone. Patients and Methods: Seventy-three patients with a mean age of 46.38 +/- 10.17 years who presented with a distal-ureteral stone were divided into four groups according to stone size and drug treatment: <5 mm without doxazosin ( group A; n = 15); 5-10 mm ( group B; n = 16); < 5 mm with doxazosin 4 mg/day for 4 weeks ( group C; n = 20); and 5-10 mm with doxazosin 4 mg/day for 4 weeks ( group D; n=22). Groups A and B served as controls for groups C and D, respectively. Results: Spontaneous stone passage was documented in 9 patients (60%) in group A v 17 (85%) in group C ( P = 0.047) and 7 ( 43.75%) in group B v 16 (72.73%) in group D ( P = 0.036). The average expulsion time was 8.78 +/- 1.09 days in group A v 7.59 +/- 0.80 days in group C ( P = 0.004) and 12.14 +/- 1.35 days in group B v 7.06 +/- 1.29 days in group D ( P < 0.0001). The number of pain episodes in group D patients was significantly lower than in group B ( P = 0.0078). Conclusions: Doxazosin treatment proved to be safe and effective for distal-ureteral stones, as determined by earlier expulsion, decreased colic frequency, and absence of side effects. The efficacy of doxazosin was significantly higher for 5- to 10-mm stones than for smaller ones.