{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T15:50:33Z","timestamp":1759161033178},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>Alpha-adrenergic receptor blockers can be effectively used in the context of medical expulsion therapy (MET) to treat ureteric stones. This study was designed to evaluate the safety and efficacy of doxazosin in MET relative to placebo or tamsulosin.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We systematically searched the PubMed, the Cochrane Library, EMBASE, Chinese Academic Database, and Web of Science databases to select randomized controlled trials (RCT) that compared the use of doxazosin with placebo or tamsulosin to treat ureteric stones. All patients we included were limited to those diagnosed with visible stones in the distal ureter. The diameter of ureteric stones does not exceed 10 mm.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Eight trials comparing doxazosin with placebo or tamsulosin containing 667 patients were assessed in the final analysis. The meta-analysis showed that doxazosin effectively treated ureteric stones and was better than placebo in terms of efficacy. Relative to the placebo group, the expulsion rate of stones from the distal ureter (OR = 3.00, 95% CI [2.15, 4.19], I2 = 0%, P &lt; 0.00001) was significantly increased, and the expulsion time (days) was shortened (mean difference) (MD) = \u22124.03, 95% CI [\u22124.53, \u22123.53], P &lt; 0.00001). The doxazosin group experienced fewer pain episodes (MD = \u22120.78, CI = [\u22120.94, \u22120.23], I2 = 0%, P &lt; 0.00001) than the placebo group. A subgroup analysis showed that the doxazosin group had a higher expulsion rate (of 5\u201310 mm stones) compared with the placebo group. Although doxazosin resulted in significantly more adverse effects compared with the placebo, the patient\u2019s symptoms were mild and no further medical interventions were required. Moreover, the expulsion time (days) was shorter for patients receiving doxazosin (MD = \u22120.61, 95% CI [\u22120.97, \u22120.24], I<jats:sup>2<\/jats:sup> = 39%, P = 0.001) than those receiving tamsulosin.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Compared with the placebo group, patients receiving doxazosin had a greater expulsion rate, a reduced expulsion time, and fewer pain episodes. The expulsion time of doxazosin was shorter than that of tamsulosin.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0245741","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T18:36:22Z","timestamp":1611599782000},"page":"e0245741","update-policy":"http:\/\/dx.doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["The safety and efficacy of doxazosin in medical expulsion therapy for distal ureteric calculi: A meta-analysis"],"prefix":"10.1371","volume":"16","author":[{"given":"Baozhong","family":"Yu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zejia","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiandong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zihao","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoyuan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feilong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"issue":"3","key":"pone.0245741.ref001","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.emc.2011.04.007","article-title":"Urolithiasis in the emergency department","volume":"29","author":"A Graham","year":"2011","journal-title":"Emerg Med Clin North Am"},{"issue":"4","key":"pone.0245741.ref002","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.urology.2007.01.009","article-title":"Comparative Evaluation of Efficacy of Use of Tamsulosin and\/or Tolterodine for Medical Treatment of Distal Ureteral Stones","volume":"69","author":"S Erturhan","year":"2007","journal-title":"Urology"},{"key":"pone.0245741.ref003","article-title":"Medical Expulsive Therapy (Alpha Blockers) for Urologic Stone Disease","author":"JC Conway","year":"2020","journal-title":"Acad Emerg Med"},{"issue":"3","key":"pone.0245741.ref004","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.eururo.2015.07.040","article-title":"EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis","volume":"69","author":"C Turk","year":"2016","journal-title":"Eur Urol"},{"issue":"2","key":"pone.0245741.ref005","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1080\/21681805.2018.1428682","article-title":"On medical treatment for ureteral stone expulsion","volume":"52","author":"D. 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