Is There a Role for Tamsulosin After Shock Wave Lithotripsy in the Treatment of Renal and Ureteral Calculi?

Abstract

At last, this study suggested that tamsulosin facilitate earlier clearance of fragments after ESWL.

Role of Tamsulosin Therapy after Extracorporeal Shockwave Lithotripsy for Renal Stones: Randomized Controlled Trial

“…Contrary to our findings, most of the investigators [12,25,26] have shown that tamsulosin facilitates earlier clearance of stone fragments. We have no proper explanation for this finding.…”

“…Gravina et al [15] in 2005, Losek and Mauro [14] in 2008, and Hossain et al [13] in 2011 found that renal SWL with adjunctive tamsulosin enhances the SFR. On the other hand, Micali et al [22] in 2007, Gravas et al [23] in 2007, Wang et al [24] in 2009, Falahatkar et al [12] in 2011, Zaytoun et al [25] in 2012 did not find any benefits of tamsulosin in increasing the SFR.…”

“…This agent has been widely investigated to improve the success rate of SWL for ureteral stones, and proved to be an effective therapy [11,12]. Also, several clinical trials [13,14,15] have proposed the benefit of tamsulosin after SWL for renal stones.…”

Shock Wave Lithotripsy for the Treatment of Ureteral Stones

“…A randomized controlled trial published in 2010 including 166 patients after SWL of renal calculi showed signifi cantly improved stone free rates at 3 months after using tamsulosin and diclofenac compared to diclofenac alone (73 % versus 55 %) [ 13 ]. Another randomized controlled trial found a signifi cant decrease in the time to stone passage in the group treated with tamsulosin compared to the placebo group [ 14 ]. A systematic review on MET after SWL by Schuler and coworkers [ 15 ] also showed a signifi cant increase in successful outcomes [ 15 ].…”

Avaliação dos fatores preditivos dos resultados da litotripsia extracorpórea por ondas de choque em cálculos renais de cálice inferior

“…Embora não se tenha encontrado diferença estatística em relação a taxa de pacientes livres de cálculos (71,4% com alfa-bloqueador versus 60,6% com placebo; p=0,116), o grupo em uso de tamsulosina eliminou mais precocemente os fragmentos de cálculos (p=0,002) [78] . Em um outro estudo randomizado com 150 doentes avaliando os resultados da tamsulosina e da doxazosina após LECO, também não se encontrou vantagens na taxa de doentes livres de cálculos (84% placebo, 92% tamsulosina, 90% doxazosina), porém pacientes em uso de tamsulosina tiveram um significativo menor tempo para expulsão dos cálculos tanto em relação à doxazosina (p=0,026) como em relação ao placebo (p=0,002), e uma menor incidência de episódios de cólicas em relação aos outros dois grupos [79] .…”