effectiveness of silodosin in medical expulsive therapy for ureteral pelvic stone from 4 to 10 mm.

Conditions: Kidney Stone; Expulsive Medical Therapy

Summary: in the diagnosis of renal colic gallstone , in addition to clinical and biological factors, it is a key : medical imaging. currently , the french recommendations require at least a couple of abdomen radiography without preparation lying face (asp ) associated with abdominal ultrasound . "the abdominopelvic ct scan without injection of contrast is the examination of choice. current recommendations in the management of gallstone colic simply based on the joint use of analgesics , anti inflammatory drugs and control of water intake . the mechanism of analgesic action of this treatment is a decrease in the pressure in the cavities by decrease in diuresis and inflammation treatment of ureteral permitting passage of urine . ) the expulsive medical therapy remains under evaluation. the french association of urology does not recommend at this time for lack of evidence deemed sufficient. for foreign companies urology (eau , aua) , the use of calcium channel blockers or alpha blockers in the treatment of symptomatic lower ureteral stones (4 to 10mm ) is recommended (grade 1a) . however, there are less formal studies of their effectiveness . investigators wish to demonstrate the effectiveness of alpha in medical expulsive therapy for pelvic stones 4 to 10mm .


Eligibility criteria:
inclusion criteria: * men * women on oral contraception (for women of childbearing age). * 18 to 60 years. * first admission to the episode of renal colic without evidence of complication (afebrile without renal input, negative beta-hcg (women of childbearing age) without severe vomiting without uropathy malformation known underlying balance sheet. ). * in ability to deliver its consent. * patient with a single calculation pelvic ureteral 4 to 10 mm cross-sectional diameter, with or without calyx calculations (not obstructive), but other calculation ureter. * unique pelvic stone : * proven by imaging: helical scan without contrast injection-asp abdominopelvic. * radio-opaque to the asp. * more than 3mm and \<11mm (4 to 10 mm) of cross-sectional diameter. exclusion criteria: * pregnant or lactating women scalable * no oral contraception * contraception by intrauterine device . * concurrent infection ( positive urine test strip for nitrites and / or general signs tanks (t ° c \> 38 ° 5 or \<36 ° 5 or chills) . * renal failure ( creatinine clearance calculated by cockcroft and gault \<60 ml / min). * single functional kidney . * treatment with calcium channel blockers or alpha blockers. * recent or upcoming cataract surgery . * orthostatic hypotension . * a history of peptic ulcer disease , liver disease , allergy to paracetamol , the ketoprofen . * history of stroke , heart disease, diabetes. * history of allergy to any treatment plans. * refusal to enter the protocol. * already included in the protocol. * medication against -indicated in combination with nsai (vitamin k ..) * hepatic impairment * participation in other biomedical research * patients with a history of hypersensitivity such as bronchospasm , asthma, rhinitis , urticaria * patients with asthma associated with chronic rhinitis, chronic sinusitis and / or nasal polyposis * history of gastrointestinal bleeding or perforation during previous treatment with nsai or history of gastrointestinal diseases such as ulcerative colitis, crohn's diseases, gastrointestinal bleeding , cerebrovascular bleeding or other bleeding evolving * patients receiving treatment associated may increase the risk of ulceration or bleeding (glucocorticoids , selective serotonin reuptake inhibitors and antiplatelet agents such as aspirin ) * patients with uncontrolled hypertension, congestive heart failure , ischemic heart disease, peripheral arterial disease, and / or a history of stroke (including transient ischemic attack) * patients treated with potassium-sparing drugs pelvic stone : * multiple * size \ 10mm * radiolucent * not formally identified by imaging.