Role of tamsulosin in the management of lower ureteric stone at tertiary care hospital in Western Rajasthan, India
DOI:
https://doi.org/10.18203/2349-2902.isj20171628Keywords:
Lower ureteral calculi, TamsulosinAbstract
Background: Many minimally invasive interventional techniques as well as expectant treatments exist for the management of lower ureteric calculi.
Methods: 100 patients [group A (50 patients) patients given capsule tamsulosin 0.4mg, 1 daily up to 4 weeks while group B (50 patients) patients given regularly practiced treatment without Tamsulosin] with distal ureteric stone included in the study. Study duration was 6 months and study performed at S.P. Medical College. Bikaner, Rajasthan, India.
Results: Group A showed a statistically significant advantage in terms of the stone expulsion rate. 41 patients (82%) in group A and 30 patients (60%) in group B expelled stones. Overall patients in group A had mean expulsion time of 7.86 days, whereas in group B mean expulsion time was 18.64 days. In group A stone expulsion rate was higher as compared to group B. In group A only 12 (24%) patients experienced pain relapses whereas in group B 32 (64%) patients reported pain relapses. The diclofenac dosage required in group A was observed to be 1.62 tablets whereas in group B it was 2.6 tablets.
Conclusions: It is concluded that tamsulosin should be considered for uncomplicated distal ureteral calculi before ureteroscopy or extracorporeal lithotripsy. Tamsulosin has been found to increase and hasten stone expulsion rates, decrease acute attacks by acting as a spasmolytic, reduces mean days to stone expulsion and decreases analgesic dose usage.
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References
Kupeli B, Biri H, Isen K. Treatment of ureteral stone: Comparison of extracorporeal shock wave lithotripsy and endourologic alternative. Eur Urol. 1998;34:474-9.
Hollings worth JM, Rogers MAM, Kaufman SR. Medical therapy to facilitate urinary stone passage: a metaanalysis. Lancet. 2006;368:1171-9.
Lingeman JE, Matlaga BR, Evan AP. Surgical management of upper urinary tract calculi. In: Kavoussi LR, Novick AC, Partin AW, Peters AC, Wein AJ, eds. Campbell-Walsh urology. Saunders Elsevier: Philadelphia; 2007:1431-1507.
Finlayan B, Ackermann D. Overview of surgical treatment of urolithiasis with special reference to lithotripsy. J Urol. 1989;141:778-9.
Eisenberger F, Fuchs G, Miller K, Bub P, Rassweiler J. Extra corporeal shock wave lithotripsy (ESWL) and endourology: an ideal combination for the treatment of kidney stones. World J Urol. 1985;3:41-7.
Stoller ML. Urinary stone disease. In: Tanagho EA, McAninch JW. Smith’s general urology. 17th ed. McGraw hill: New York; 2008:246-277.
Borghi L, Meschi T, Amato F. Nifedipine and methylprednisolone in facilitating ureteral stone passage: a randomized double-blind placebo-controlled study. J Urol. 1994;152:1095-8.
Michael L, Shah O, The use of alpha blockers for the treatment of nephrolithiasis. Rev Urol. 2006;8(4):S35-42.
Weiss RM, Bassett AL, Hoffman BF. Adrenergic innervation of the ureter. Invest Urol. 1978;16:123-7.
Morita T, Wada I, Saeki H. Ureteral urine transport: changes in bolus volume, peristaltic frequency, intraluminal pressure and volume of flow resulting from autonomic drugs. J Urol. 1987;137:132-5.
Davenport K, Timoney AG, Keeley FX. A comparative in vitro study to determine the beneficial effect of calcium-channel and alpha (1)-adrenoceptor antagonism on human ureteric activity. BJU Int. 2006;98:651-5.
Cervenakov I, Fillo J, Mardiak J. Speedy elimination of ureterolithiasis in lower part of ureters with the alpha 1-blocker tamsulosin. Int Urol Nephrol. 2002;34:25-9.
Yilmaz E, Batislam E, Basar MM. The comparison and efficacy of 3 different alpha1-adrenergic blockers for distal ureteral stones. J Urol. 2005;173:2010-2.
Deliveliotis C, Chrisofos M, Gougousis E. Is there a role for alpha1-blockers in treating double-J stent-related symptoms? Urology. 2006;67:35-9.
Gupta G, Aswathaman K, Kekre NS. Does tamsulosin facilitate expulsion of distal ureteric calculus following lithotripsy. Indian J Urol. 2008;24(2):274-5.
Griwan MS, Singh SK, Paul H, Pawar DS, Verma M. The efficacy of Tamsulosin in lower ureteral calculi. Urol Ann. 2010;2(2)63-6.
Vincendeau S, Bellissant E, Houlgatte A, Doré B, Bruyère F, Renault A, et al. Tamsulosin hydrochloride vs placebo for management of distal ureteral stones. A multicentric, randomized, double blind trial. Arch Intern Med. 2010;170(22):2021-7.
Dellabella M, Milanese G, Muzzonigro G. Efficacy of tamsulosin in the medical management of juxtavesical ureteral stones. J Urol. 2003;170(6):2202-5.
Abdulla AA, Abdulla AN, Abdul KA, Khalid A, Mohamed D, Ahmed A. Efficacy of tamsulosin in the management of lower ureteral stones: a randomized double-blind placebo-controlled study of 100 patients. Urology. 2010;75(1):4-7.
Ferre M, Jessica MW, Tania DS. Tamsulosin for ureteral stones in the emergency department: a randomized, controlled trial. Ann Emerg Med. 2009;54(3):432-9.
Sayed MAB, Abolyosr A, Abdalla MA, El-Azab AS. Efficacy of tamsulosin in medical expulsive therapy for distal ureteral calculi. Scandinavian J Urol Nephrol. 2008;42(1)
Resim S, Ekerbicer H, Ciftci A. Effect of tamsulosin on the number and intensity of ureteral colic in patients with lower ureteral calculus. Int J Urol. 2005;12:615-20.
Ahmad H, Azim W, Akmal M, Murtaza B, Mahmood A, Nadim A, et al. Medical expulsive treatment of distal ureteral stone using tamsulosin. J Ayub Med Coll Abbottabad. 2015;27(1):4850.
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