The efficacy of tamsulosin in lower ureteral calculi

Abstract

Context:There has been a paradigm shift in the management of ureteral calculi in the last decade with the introduction of new less invasive methods, such as ureterorenoscopy and extracorporeal shock wave lithotripsy (ESWL).Aims:Recent studies have reported excellent results with medical expulsive therapy (MET) for distal ureteral calculi, both in terms of stone expulsion and control of ureteral colic pain.Settings and Design:We conducted a comparative study in between watchful waiting and MET with tamsulosin.Materials and Methods:We conducted a comparative study in between watchful waiting (Group I) and MET with tamsulosin (Group II) in 60 patients, with a follow up of 28 days.Statistical Analysis:Independent 't' test and chi-square test.Results:Group II showed a statistically significant advantage in terms of the stone expulsion rate. The mean number of episodes of pain, mean days to stone expulsion and mean amount of analgesic dosage used were statistically significantly lower in Group II (P value is 0.007, 0.01 and 0.007, respectively) as compared to Group I.Conclusions:It is concluded that MET 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.

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

“…21 M S Griwan et al observed that group II (tamsulosin group) showed a statistically significant advantage in terms of mean number of pain episodes. 16 In present study mean time of stone expulsion for group A and B were 7.86 and 18.64 days respectively with difference of 11 days in both groups. Among stone sized based categories also stone expulsion time of group A was lesser as compared to group B.…”

Eficacia y seguridad de tamsulosina para el tratamiento conservador del cólico nefrítico: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados

“…El tamañ o medio de las litiasis osciló entre 2,9 29 y 7,9 mm 48 . Cuatro de los artículos incluidos especifican que má s del 60% de los pacientes presentaron litiasis mayores de 5 mm 14,34,36,48 .…”

Predictive Factors for Spontaneous Stone Passage and the Potential Role of Serum C-Reactive Protein in Patients with 4 to 10 mm Distal Ureteral Stones: A Prospective Clinical Study

“…compared to conservative management(1,2,15). Most of the distal ureteral stones particularly smaller than 5-6 mm can potentially pass spontaneously(1,7).…”