Image not available

Singh SK et al, 2011: Role of tamsulosin in clearance of upper ureteral calculi after extracorporeal shock wave lithotripsy: a randomized controlled trial

Singh SK, Pawar DS, Griwan MS, Indora JM, Sharma S.
Department of Urology, Pt. B.D. Sharma University of Health Sciences, Rohtak, India.


Abstract

PURPOSE: To evaluate the role of tamsulosin in stone clearance in patients with upper ureteral stone after extracorporeal shock wave lithotripsy (SWL).

MATERIALS AND METHODS: This randomized controlled trial was performed on 117 patients with a single upper ureteral calculus undergoing SWL. The study group received 0.4 mg tamsulosin daily while the control group received hydration and analgesic on demand for a maximum of 3 months. Follow-up visits were performed at 1, 2, and 3 months after SWL. Efficiency of tamsulosin was evaluated in terms of success rate, time for expulsion of fragments, number of SWL sessions, incidence of steinstrasse, and pain intensity.

RESULTS: The clearance rate after 1, 2, and 3 months were higher in tamsulosin group than the control group (85%, 89.8%, and 91.5% versus 70.6%, 79.3%, and 86.2%; P = .01, P = .11, and P = .34, respectively). The mean time for expulsion of the fragments was 26.78 ± 11.96 days and 31.28 ± 18.31 days in tamsulosin and control groups, respectively (P = .138). Steinstrasse developed in 8 patients in tamsulosin group and in 13 patients in control group (P = .167). Visual analogue scale pain score was 24.92 ± 7.57 in tamsulosin group and 41.81 ± 17.24 in control group (P = .000).

CONCLUSION: Tamsulosin helps in clearance of upper ureteral stones after 1 month of SWL, particularly stones with size of 11 to 15 mm with less requirement of SWL sessions and analgesics.

Urol J. 2011 Winter;8(1):14-20
PMID:21404197 [PubMed - in process]

Rate this blog entry:
0
 

Comments 1

Hans-Göran Tiselius on Friday, 03 June 2011 09:11

The drawback of ESWL is that the stone-clearance is lower or slower than desireable. Several pharmacological attempts have been made with the aim of eliminating residual fragments both in the kidney and the ureter.

The positive effects recorded for facilitating stone and fragment passage from the distal ureter by means of α-adrenergic receptor blocking agents have been extrapolated to the proximal ureter despite the fact that the receptors have the greatest density in the distal ureter.

This randomized controlled trial showed a higher grade of fragment clearance and a much lower pain score for patients treated with tamsulosin after ESWL of stones located in the proximal ureter. The ESWL was carried out with the Chinese Hk-ESWL-VI Shenzen lithotripter.

The study shows that it is worthwhile to give of α-adrenergic receptor blocking agents for stones also in the proximal ureter, at least following ESWL.

Hans-Göran Tiselius

The drawback of ESWL is that the stone-clearance is lower or slower than desireable. Several pharmacological attempts have been made with the aim of eliminating residual fragments both in the kidney and the ureter. The positive effects recorded for facilitating stone and fragment passage from the distal ureter by means of α-adrenergic receptor blocking agents have been extrapolated to the proximal ureter despite the fact that the receptors have the greatest density in the distal ureter. This randomized controlled trial showed a higher grade of fragment clearance and a much lower pain score for patients treated with tamsulosin after ESWL of stones located in the proximal ureter. The ESWL was carried out with the Chinese Hk-ESWL-VI Shenzen lithotripter. The study shows that it is worthwhile to give of α-adrenergic receptor blocking agents for stones also in the proximal ureter, at least following ESWL. Hans-Göran Tiselius
Guest
Thursday, 17 August 2017
STORZ MEDICAL AG
Lohstampfestrasse 8
8274 Tägerwilen
Switzerland
Tel.: +41 (0)71 677 45 45
Fax: +41 (0)71 677 45 05

www.storzmedical.com
Personal data
Address
Contact data
Message