tamsulosin (Hanmi Tams / tamsulosin, Hanmi / HIP 1402)

Effect of Tamsulosin Combined With Flexible Ureteroscopic Holmium Laser Lithotripsy on Renal Function and Postoperative Inflammatory Response in Patients With Renal Calculi.

Jiang Xiaoxiang X, Ying Lihong L

To investigate the association between perioperative tamsulosin use and outcomes of flexible ureteroscopic holmium laser lithotripsy (FURL). This retrospective cohort study was performed on 122 patients who underwent FURL at Cixi People's Hospital, Wenzhou Medical University. Patients were divided into an observation group (perioperative tamsulosin + FURL, n = 62) and a control group (FURL alone, n = 60) according to routine clinical protocols and patient preference. Operation time, stone clearance rate at 4 weeks postoperatively, renal function indicators, inflammatory markers, and complication rates were compared between the two groups. Compared with the control group, the observation group had shorter operation time (51.34 ± 9.28 vs. 58.62 ± 10.35 min, p < 0.001), shorter postoperative hospital stay (3.62±1.05 vs. 4.85±1.23 days, p < 0.001), and a higher stone clearance rate (93.55% vs. 75.00%, p = 0.005). On postoperative day 1 and at week 1, renal function indicators were significantly lower in the observation group (all p < 0.05). Serum inflammatory marker levels on postoperative days 1 and 3 were also significantly lower in the observation group (all p < 0.001). The total complication rate was lower in the observation group (8.06% vs. 21.66%, p = 0.036). In this retrospective study, perioperative tamsulosin combined with FURL was associated with shorter operation times, higher stone clearance, and lower renal function, inflammatory, and complication markers. However, due to potential selection bias, these associations require confirmation via prospective randomized controlled trials.

ASIV Attenuates Cisplatin-Induced Proximal Tubular Injury by Enhancing Mitochondrial Biogenesis and Mitophagy Through the ADRA1A/AMPK/FOXO3A Pathway.

Wang Meng M, Peng Wang W, Wei Yani Y, Yu Hangxing H et al.

Cisplatin causes nephrotoxicity by accumulating in renal tubular epithelial cells (RTECs). Astragaloside IV (ASIV) shows renoprotective potential, but its mechanisms remain poorly understood. Cisplatin induced nephrotoxicity was established in 8-week-old male C57BL/6 mice via intraperitoneal administration of cisplatin at 20 mg/kg for 48 h. For in vitro studies, HK-2 human proximal tubular epithelial cells were exposed to 50 μM cisplatin for 24 h. Multi-omics approaches were employed to identify novel mechanisms by which ASIV ameliorates cisplatin-induced proximal tubular injury. ASIV markedly reduced serum creatinine and urea nitrogen levels in mice, and ameliorated cisplatin-induced proximal tubular injury both in vivo and in vitro. Moreover, ASIV restored mitochondrial damage, upregulated protein expression of PGC-1α, TOMM20, and PINK1 in RTECs. Mechanistically, RNA-seq and scRNA-seq revealed that cisplatin predominantly affected ADRA1A-mediated mitochondrial biogenesis and mitophagy in proximal tubular cells, accompanied by suppression of the AMPK/FOXO3A pathway. Notably, ASIV upregulated ADRA1A expression, thereby facilitating AMPK and FOXO3A phosphorylation and consequently enhancing mitochondrial biogenesis and mitophagy. Furthermore, dabuzalgron (a selective ADRA1A agonist) recapitulated the protective effects of ASIV. In contrast, the renoprotective action of ASIV against cisplatin-induced proximal tubular injury was largely abrogated by the ADRA1A antagonist tamsulosin in vivo and by ADRA1A-specific siRNA in vitro. These findings identify ASIV as a highly promising renoprotective agent that upregulates ADRA1A expression and activates the AMPK/FOXO3A axis to enhance mitochondrial biogenesis and mitophagy, thereby counteracting cisplatin-induced proximal tubular injury.

The silent signal is tadalafil counterbalancing tamsulosin induced ejaculatory dysfunction.

Zhang Tao T, Yu Maobin M

Tamsulosin versus tamsulosin plus tolterodine for the treatment of distal ureteral stones.

Mohseni-Rad Hamed H, Imani Geshlaghchayi Houshyar H, Iranpour Sohrab S

This study aimed to compare the efficacy of tamsulosin monotherapy versus tamsulosin combined with tolterodine for facilitating the expulsion of distal ureteral stones. A prospective, randomized controlled trial was conducted between 2022 and 2023 at the Urology Clinic of Imam Reza Hospital, Ardabil. A total of 120 patients diagnosed with distal ureteral stones (4-10 mm in size) were randomized into two groups: Group A received 0.4 mg tamsulosin daily, and Group B received 0.4 mg tamsulosin daily plus 2 mg tolterodine twice daily. Treatment duration was up to 4 weeks. Primary outcomes included stone expulsion rate and expulsion time. Secondary outcomes comprised pain control (visual analog scale, VAS), analgesic requirement, and incidence of side effects. The two groups were comparable at baseline in terms of demographic and stone characteristics. The stone expulsion rate was significantly higher in Group B (tamsulosin + tolterodine) at 83.3% (50/60) compared to Group A (tamsulosin alone) at 66.7% (40/60) (p = 0.03). The mean stone expulsion time was also significantly shorter in Group B (10.5 ± 3.2 days) compared to Group A (14.8 ± 4.1 days) (p < 0.001). Patients in Group B reported lower mean pain scores (VAS) and required less rescue analgesia. The incidence of adverse effects was comparable between the groups, with dry mouth being slightly more common in Group B. The combination of tamsulosin and tolterodine demonstrated superior efficacy in terms of stone expulsion rate and reduced expulsion time for distal ureteral stones compared to tamsulosin monotherapy. This combination therapy may offer a more effective medical expulsive therapy option for patients with distal ureteral calculi.