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Qadri SS et al, 2015: Effects and outcome of Tamsulosin more than just stone clearance after extracorporeal shock wave lithotripsy for renal calculi.

Qadri SS, El Khalid S, Mahmud SM

Abstract

OBJECTIVE: To determine the effect of Tamsulosin, as adjunctive medical therapy after Extracorporeal Shock Wave Lithotripsy for renal stones on rate of stone clearance, clearance time, pain intensity during stone clearance, steinstrasse formation and auxiliary surgical intervention required. METHOD: A prospective randomized controlled study was carried out in 120 patients who undeiwent ESWL for renal stones of 0.5-2.0 cm. They were randomized into study and control group in which Tamsulosin 0.4 mg/day was given in former as an adjunctive medical therapy. All patients underwent ESWL every 2 weeks until complete stone clearance for 8 weeks. The parameters assessed were stone clearance, clearance time, pain intensity and effect on steinstrasse.
RESULTS: Of the 120 patients 60 were in each group. The stone clearance rate was greater in study than in control group, 58 (96.7%) vs. 48 (80%) respectively, (p < 0.004). The mean stone clearance time was observed earlier in study group as compared to control group with significant statistical difference in stone size between 0.6-1.Scm.The mean intensity of pain patients experienced according to Visual analogue scale (VAS) was significantly less in study group (p < 0.002). The rate of steinstrasse formation was observed to be higher in control than in study group 15 (25%) vs 6 (10%) respectively (p < 0.003), while its spontaneous clearance was higher in study group than in control group 83.3% vs 33.3% (p < 0.03). CONCLUSION: Tamsulosin significantly increases stone clearance after shock wave lithotripsy for renal stones. It also appeared to facilitate earlier stone clearance, reduces severity of pain, reduces the incidence of steinstrasse formation and tends to facilitate its spontaneous
clearance. 

J Pak Med Assoc. 2014 Jun;64(6):644-8.

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Comments 1

Hans-Göran Tiselius on Tuesday, 14 April 2015 10:20

This article presents clinically very useful information. Most previous studies on -receptor antagonists used in association with SWL have had focus on stones in the ureter. In this prospective randomized study on patients treated for stones in the kidney, one group was given Tamsulosin 4 mg daily and a control group was left without -blockage.

The majority of stones were located in the renal pelvis, but more than 20% of the patients were treated for stones in the lower calyx.

http://www.storzmedical.com/images/blog/Artikel_Tiselius_002.jpg

In addition to the better stone clearance summarized in the table above, patients treated with Tamsulosin had shorter time to stone clearance, less pain and lower frequency of steinstrasse.

These results need attention and suggest that -receptor antagonists advantageously might be given routinely to patients (who tolerate this medication) after SWL and not only to patients with stones in the distal ureter.

This article presents clinically very useful information. Most previous studies on -receptor antagonists used in association with SWL have had focus on stones in the ureter. In this prospective randomized study on patients treated for stones in the kidney, one group was given Tamsulosin 4 mg daily and a control group was left without -blockage. The majority of stones were located in the renal pelvis, but more than 20% of the patients were treated for stones in the lower calyx. [img]http://www.storzmedical.com/images/blog/Artikel_Tiselius_002.jpg[/img] In addition to the better stone clearance summarized in the table above, patients treated with Tamsulosin had shorter time to stone clearance, less pain and lower frequency of steinstrasse. These results need attention and suggest that -receptor antagonists advantageously might be given routinely to patients (who tolerate this medication) after SWL and not only to patients with stones in the distal ureter.
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