Role of tamsulosin in the management of lower ureteric stone at tertiary care hospital in Western Rajasthan, India

Abstract

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.

Tamsulosin versus Fluid Therapy in Management of Ureteric Stone: A Comparative Study

“…Similar results were found in the study carried out by Chandawat et al where the Tamsulosin group had a mean expulsion time of 7.86 days, whereas in high fluid group, the mean expulsion time was 18.64 days. 15 Use of analgesics was lower in Group A in comparison to Group B. Also, in group A only 26.0% (13 patients) subjects experienced recurrent attacks of pain, whereas 64.0% (32 patients) subjects in group B experienced recurrent attacks of pain.…”

“…Medical expulsion therapy is gaining attention currently as it is known to promote spontaneous stone expulsion and alleviate pain. 15 The pharmacological action of alpha blockers in augmenting stone expulsion could be attributed to reduction in spasm, increase in pressure proximal to the stone and dilatation/ relaxation of the ureter at the sites distal to the stone. The basis in incorporating these agents in expulsive therapy is their proficiency in reducing ureteral contractions, decreasing the regularity of peristaltic contractions and increasing the amount of fluid bolus transported down the ureter.…”