Falahatkar S et al, 2010: Is there a role for tamsulosin after shock wave lithotripsy in the treatment of renal and ureteral calculi?
Falahatkar S, Khosropanah I, Vajary AD, Bateni ZH, Khosropanah D, Allahkhah A.
Department of Urology, Urology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
INTRODUCTION: Our study aimed at defining the role of tamsulosin as adjunctive therapy after extracorporeal shock wave lithotripsy (ESWL) in patients with stones in the kidney and ureter.
MATERIALS AND METHODS: A placebo-controlled, randomized, double-blind clinical trial prospectively performed between February 2008 and September 2009 on 150 patients with 4-20 mm in diameter renal and ureteral stones referred to our ESWL center. After ESWL, all patients randomly assigned to two groups (placebo and tamsulosin). The drugs administration was started immediately after ESWL and was continued for a maximum of 30 days.
RESULTS: From 150 patients, 71 in control group and 70 in case group completed the study. Of 71 patients (60.56%) in control group, 43 patients became stone free; and other patients (39.44%) did not succeed in stone expulsion during 12 weeks after ESWL. In case group of 70 patients (71.4%), 50 patients became stone free. Time of stone passage in most of the patients happened between 20th and 30th day in control group (32.6%) and between 10th and 20th day (50%) in case group after ESWL. There is no statistically significant difference between stone passage in two groups (p = 0.116) and location of stone (p = 0.114), but there is statistically significant difference in time of stone passage from onset of treatment in case and control groups (p = 0.002).
CONCLUSION: At last, this study suggested that tamsulosin facilitate earlier clearance of fragments after ESWL.
J Endourol. 2011 Mar;25(3):495-8. doi: 10.1089/end.2010.0439. Epub 2010 Dec 18
PMID: 21166579 [PubMed - in process]
This prospective placebo-controlled, randomized, double blind trial evaluated the effect of the alpha1-adrenergic blocker Tamsulosin in 150 patients with ESWL or renal (85%) and ureteral stones treated with an electromagnetic lithotripter.
The most important result was a reduced time to stone clearance with Tamsolusin (50 % within 10 – 20 days after ESWL) compared to placebo (32,6% within 20 – 30 days).
The overall stone clearance rate was not different (Tamsolusin vs. Placebo: 60,5% vs.71,4%)
The paper suffers al little bit from a paucity of data: the lithotripsy procedure is not adequately described, the localisation of the kidney stones is not presented, the follow up is only 3 months, and a detailed analysis of the time to stone clearance is not given for the whole follow up period.