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. 2018 Apr 5;2018(4):CD008509. doi: 10.1002/14651858.CD008509.pub3

Mshemish 2012.

Methods
  • Study design: prospective single‐blind RCT.

  • Study duration: January to May 2011.

  • Follow‐up/Treatment duration: 45 days.

Participants
  • Country: Iraq.

  • Setting: single centre.

  • All male and female patients ≥ 18 years presenting with acute renal colic were evaluated for study participation. Patients with a single ureteral stone ≤ 10 mm below the common iliac vessels were eligible for inclusion in the study.

  • Number: treatment group 1/tamsulosin group: 33; treatment group 2/doxazosin group: 33; control group: 34.

  • Mean age ± SD, years: treatment group 1: 44.3 ± 12.5; treatment group 2: 45.1 ± 11.6; control group: 43.8 ± 13.2.

  • Sex, M/F: treatment group 1: 23/10; treatment group 2: 21/12; control group: 24/10.

  • Exclusion criteria: presence of multiple ureteral stones; hydronephrosis; renal dysfunction; urinary tract infection; a solitary kidney; pregnancy; history of ureteral surgery or previous endoscopic procedures; hypersensitivity to α‐blocker; current α‐blocker, calcium antagonist, or corticosteroid.

Interventions Treatment group 1/tamsulosin group
  • Tamsulosin 0.4 mg daily.


Treatment group 2/doxazosin group
  • Doxazosin 4 mg daily.


Control group
  • First treatment with meloxicam (15 mg) by IM injection, with a second dose after 30 minutes if necessary.

Outcomes
  • Stone expulsion rate.

  • Stone expulsion time.

  • Frequency of pain attacks.

  • Complications of medication.

Funding sources None stated.
Declarations of interest None stated.
Notes Follow‐up weekly with urine analysis, serum creatinine measurement, KUB, and US NCCT at the end of the study.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk No quotes available.
Comment: randomisation stated but no information on method used was available; therefore risk of selection bias was considered to be unclear.
Allocation concealment (selection bias) Unclear risk No quotes available. Insufficient information to permit judgement.
Comment: Owing to insufficient information, allocation concealment was considered to have unclear risk of bias.
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk No quotes available. Blinding was not described in detail.
Comment: Owing to insufficient information, risk of performance bias was considered to be unclear.
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk No quotes available. No blinding of outcome assessments described.
Comment: Owing to insufficient information, risk of detection bias was considered to be unclear.
Incomplete outcome data (attrition bias) 
 All outcomes High risk No quotes available.
Comment: no intention‐to‐treat analysis used and 5 participants lost to follow‐up; therefore risk of attrition bias was considered to be high.
Selective reporting (reporting bias) Unclear risk No quotes available.
Comment: Owing to insufficient information to permit judgement, risk of reporting bias was considered to be unclear.
Other bias High risk No quotes available.
Comment: Owing to incorrect data for stone clearance stratified for stone size, information is not interpretable and risk of other sources of bias was considered to be high.