The Effect of Tamsulosin on Stone Free Rate after SWL: A Placebo Controlled Study

Abstract

Background: Extracorporeal Shock Wave Lithotripsy (ESWL) is a noninvasive technique for the treatment of kidney stones. Most ESWL is carried out when the stone is present in the renal pelvis. Aim of Study:To evaluate the efficacy of alpha blocker (tamsulosin) to enhance stone fragments clearance from urinary tract after ESWL on renal pelvic stones.Methods: This is prospective randomized study which was carried out at Urology Department Ain Shams University Hospital during the period from August 2017 till July 2018. After hospital ethical committee approval, a total of 56 patients fulfilling inclusion criteria with symptomatic single renal pelvic radiopaque stone ≤ 1cm were included in this study. All patients underwent ESWL therapy for their stone. Patients were randomized into two groups; group A (received tamsulosin 0.4mg) and group B (received placebo).Results: After two weeks of follow up PUT was done and revealed post ESWL SFR (stone free rate) on placebo group was 86.9% and SFR on tamsulosin group was 92.5% ( p-value=0.2) (no statistically significant difference) on the other hand post ESWL pain was significantly more among group B (placebo group) of 73.9% compared to group A (tamsulosin group) of 3.7% (p-value=0.0023), and Dizziness in tamsulosin group was 18.5% of the group patients experienced it while none of the placebo group complained of that, ( p-value= 0.003). Conclusion:When the stones were (≤ 10mm, no improvement was seen in the success rates by adding Medical Expulsive Therapy (MET) in the form of alpha blocker than placebo, as has been reported in other studies, but post ESWL pain is less with adding tamsulosin.