Efficacy of tamsulosin in medical expulsive therapy for distal ureteral calculi.

Abstract

OBJECTIVE:

To evaluate the potential role of tamsulosin in the medical treatment of distal ureteral stones.

MATERIAL AND METHODS:

Ninety patients with symptomatic distal ureteral calculi were enrolled. They were randomly divided into two groups: Group A (n=45) received diclofenac 100 mg on demand for 4 weeks plus levofloxacin 250 mg daily for the first week and were well hydrated; and Group B (n=45) received the same therapy plus tamsulosin 0.4 mg/daily for 4 weeks. Abdominal ultrasound scans and KUB X-rays were performed weekly. Stone expulsion rates, time to expulsion, pain episodes and analgesic usage were determined. Intervention by means of shock-wave lithotripsy (SWL) or ureteroscopy was evaluated.

RESULTS:

The stone expulsion rate was 51.1% for Group A, compared to 88.9% for Group B (p=0.001). The average time to expulsion was 12.53+/-2.12 days for Group A and 7.32+/-0.78 days for Group B (p=0.04). The number of pain episodes was significantly lower in Group B and mean use of analgesics was lower for Group B (0.14+/-0.5 vials) than Group A (2.78+/-2.7 vials). Twenty-two patients in Group A failed to pass their stones after 4 weeks but only five in Group B. Of the patients who were not stone-free, 19 were treated with SWL and eight underwent ureteroscopy.

CONCLUSION:

Our study reveals the efficacy of tamsulosin for the treatment of distal ureteral stones. Tamsulosin should be added to the standard medical approach for treating these stones.

• Authors: Mohamed Abdel-Basir Sayed, Ahmad Abolyosr, Medhat Ahmad Abdalla, Ahmad Shehata El-Azab
• Journal: Scandinavian journal of urology and nephrology (Scand J Urol Nephrol) Vol. 42 Issue 1 Pg. 59-62 ( 2008) ISSN: 0036-5599 [Print] England
• PMID: 17853008 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Adrenergic alpha-Antagonists
• Anti-Inflammatory Agents, Non-Steroidal
• Sulfonamides
• Diclofenac
• Tamsulosin

Topics

• Adolescent
• Adrenergic alpha-Antagonists (therapeutic use)
• Adult
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Diclofenac (therapeutic use)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Sulfonamides (therapeutic use)
• Tamsulosin
• Time Factors
• Treatment Outcome
• Ureteral Calculi (diagnosis, drug therapy)