L-arginine role for stone lower ureter: A randomized controlled trial

Area of Science:

• Urology
• Nephrology
• Pharmacology

Background:

• Lower ureteral stones are a common clinical issue.
• Medical expulsive therapy (MET) is a standard treatment approach.
• Evaluating novel MET agents is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the efficacy of L-arginine 1000 mg once daily as a MET for lower ureteral stones.
• To compare L-arginine with placebo and tamsulosin in a randomized controlled trial.

Main Methods:

• Prospective, randomized controlled study involving 153 patients with ureteral stones.
• Three groups: placebo, L-arginine 1000 mg daily, and tamsulosin 0.4 mg daily.
• Evaluation of spontaneous stone expulsion rates (SER), expulsion time, pain episodes, analgesic use, stone density, and hydronephrosis over 4 weeks.

Main Results:

• L-arginine demonstrated a significantly higher SER (94.1%) compared to tamsulosin (31.4%) and placebo (11.8%) (p < 0.001).
• No significant difference in stone expulsion time, daily colic episodes, or analgesic dosage among groups.
• Significant differences observed in stone density and hydronephrosis, favoring L-arginine.

Conclusions:

• L-arginine 1000 mg once daily is a safe and effective MET for lower ureteral stones.
• L-arginine shows superior efficacy over tamsulosin in increasing SER and potentially improving pain control.
• Further research may explore L-arginine's role in managing ureteral calculi.