Video Experimental Relacionado
Updated: Jul 9, 2026
06:39
Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
Published on: November 22, 2019
Terapia médica para facilitar el paso de las piedras urinarias: un metanálisis
John M Hollingsworth1, Mary A M Rogers, Samuel R Kaufman
1Department of Urology, Ann Arbor Veterans Affairs Health Services Research & Development Center of Excellence, Ann Arbor, MI, USA.
Lancet (London, England)
|October 3, 2006
Resumen
Las terapias médicas como los bloqueadores alfa y los bloqueadores de los canales de calcio aumentan significativamente las tasas de paso de piedras urinarias. Estos tratamientos ofrecen una alternativa potencial a la cirugía para muchos pacientes con cálculos renales.
Área de la Ciencia:
- Urología Urología Urología.
- Farmacología Farmacología.
- La medicina basada en la evidencia.
Sus antecedentes:
- Las terapias médicas para el paso de cálculos urinarios están subutilizadas.
- Los tratamientos médicos efectivos podrían ampliar las opciones terapéuticas para los cálculos urinarios.
- Este estudio evalúa la eficacia de clases específicas de fármacos en el paso de piedra.
Objetivo del estudio:
- Revisar sistemáticamente los ensayos controlados aleatorios (ECA) sobre bloqueadores alfa y bloqueadores de los canales de calcio para la enfermedad de cálculos urinarios.
- Evaluar la efectividad de estas terapias médicas para facilitar el paso de las piedras.
Principales métodos:
- Buscado en las principales bases de datos (MEDLINE, EMBASE, CINAHL) y resúmenes de reuniones hasta julio de 2005.
- Incluidos los ECA que utilizan bloqueadores alfa o bloqueadores de los canales de calcio para cálculos ureteros.
- Datos agrupados de nueve ensayos (693 pacientes) utilizando el metanálisis.
Principales resultados:
- Los bloqueadores alfa y los bloqueadores de los canales de calcio aumentaron el paso de las piedras en un 65% (RR 1.65).
- Las clases específicas de medicamentos mostraron proporciones de riesgo agrupadas significativas: bloqueadores alfa (1.54) y bloqueadores de los canales de calcio con esteroides (1.90).
- El número necesario para tratar era 4, lo que indica una alta eficiencia.
Conclusiones:
- La terapia médica con bloqueadores alfa o bloqueadores de los canales de calcio es una opción viable para facilitar el paso de cálculos urinarios.
- Estos tratamientos pueden ayudar a los pacientes a evitar intervenciones quirúrgicas.
- Se recomiendan otros ECA de alta calidad para confirmar la eficacia.
Videos de Conceptos Relacionados
01:28Urinary Tract Calculi I: Introduction
Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
01:30Urinary Tract Calculi III: Medical Management
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
01:28Urinary Tract Calculi V: Nursing Management
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
01:25Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
01:29Urine Studies I: Urinalysis
Urinalysis is a widely used diagnostic test that analyzes urine's physical, chemical, and microscopic characteristics. Healthcare providers use it to detect and monitor various health conditions, including renal disease, urinary tract infections (UTIs), diabetes, and metabolic or systemic disorders.Components of UrinalysisUrinalysis consists of three primary components: physical, chemical, and microscopic examination. Each provides unique insights into the urine sample and, by extension, the...