{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T16:18:11Z","timestamp":1770999491596,"version":"3.50.1"},"reference-count":0,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2018,9,18]],"date-time":"2018-09-18T00:00:00Z","timestamp":1537228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2018,9,18]],"date-time":"2018-09-18T00:00:00Z","timestamp":1537228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Urol Int"],"published-print":{"date-parts":[[2019]]},"abstract":"<b><i>Objectives:<\/i><\/b> To assess the safety and efficacy of bromelain plus tamsulosin versus tamsulosin alone as medical expulsive therapy (MET) for promoting spontaneous stone passage (SSP) of symptomatic distal ureter stones. <b><i>Patients and Methods:<\/i><\/b> One-hundred-fourteen patients with a 4\u201310 mm distal ureteral stone were enrolled (Group A). Patients self-administered daily bromelain with tamsulosin for 30 days or until SSP or intervention was mandatory. Patients were compared to those from a control group taking tamsulosin as MET (Group B) and matched for the following factors: sex, age \u00b110%, stone diameter. A logistic regression model evaluated bromelain and the ureteral stone diameter as explanatory variables. <b><i>Results:<\/i><\/b> SSP rates were 87.7 vs. 75.4% for group A vs. group B respectively (<i>p<\/i> = 0.016); with no difference observed for the time to self-reported stone expulsion (11.68 vs. 11.57 days; <i>p<\/i> = 0.91). Considering larger stones (&#x3e; 5 mm), the SSP rate was 83.3% in group A and 61% in group B (<i>p<\/i> &#x3c; 0.01). With each millimeter increment of stone diameter, the probability of SSP decreased by 59.1% (<i>p<\/i> &#x3c; 0.0001), while it increased of 3.3 when bromelain was present. Only 3 cases of tamsulosin-related adverse events were recorded. <b><i>Conclusion:<\/i><\/b> The association of bromelain and tamsulosin as MET increases the probability of SSP of symptomatic distal ureteral stones, with no bromelain-related side effects recorded.<\/jats:p>","DOI":"10.1159\/000493158","type":"journal-article","created":{"date-parts":[[2018,9,18]],"date-time":"2018-09-18T21:01:20Z","timestamp":1537304480000},"page":"145-152","source":"Crossref","is-referenced-by-count":7,"title":["Medical Expulsive Therapy for Symptomatic Distal Ureter Stones: Is the Combination of Bromelain and Tamsulosin More Effective than Tamsulosin Alone? Preliminary Results of a Single-Center Study"],"prefix":"10.1159","volume":"102","author":[{"given":"Franco","family":"Palmisano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo\u00a0Giulio","family":"Spinelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9373-1413","authenticated-orcid":false,"given":"Stefano","family":"Luzzago","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Boeri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"De\u00a0Lorenzis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Albo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Gadda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Gelosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Longo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo\u00a0Guido","family":"Dell\u2019Orto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Montanari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2018,9,18]]},"container-title":["Urologia Internationalis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/493158","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/493158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:48:47Z","timestamp":1745426927000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000493158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,18]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,3,21]]},"published-print":{"date-parts":[[2019,3,26]]}},"URL":"https:\/\/doi.org\/10.1159\/000493158","archive":["Portico"],"relation":{},"ISSN":["0042-1138","1423-0399"],"issn-type":[{"value":"0042-1138","type":"print"},{"value":"1423-0399","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,18]]}}}