The efficacy of tamsulosin therapy after extracorporeal shock-wave lithotripsy for ureteric calculi: A prospective randomised, controlled study

Mohamed, Hassan Ismail

doi:10.1016/j.aju.2013.08.013

Cited by 14 publications

(10 citation statements)

References 26 publications

(56 reference statements)

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Ahmed

Shalaby²,

El-Feky³

et al. 2016

Urol Int

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Introduction: To evaluate the efficacy of adjunctive tamsulosin therapy after extracorporeal shockwave lithotripsy (SWL) for renal stones. Materials and Methods: This prospective study was conducted on patients who underwent single-session SWL for solitary renal stone less than 20 mm. Post-SWL, patients were randomly divided into 2 groups; the tamsulosin group (TG), received a daily dose of tamsulosin 0.4 mg, for a maximum of 12 weeks, with post-SWL traditional analgesia and control group (CG), received the traditional analgesia alone. Results: The study enrolled 271 patients and eventually only 249 (123 in TG and 126 in CG) completed the study. The overall stone free rate was 73.5%: 78.0% in TG and 69.0% in CG (p = 0.108). In TG, 8.1% of patients experienced at least one episode of acute renal/ureteral colic compared with 19.8% of controls (p = 0.008). The mean cumulative analgesia dosage per subject was 313 mg in TG and 346 mg in CG (p < 0.001). Overall, 14 patients developed steinstrasse and 6 of them (all in CG) needed urgent intervention (p = 0.031). Conclusions: Daily tamsulosin therapy does not enhance the clearance of stone fragments but decreases the pain episodes, analgesia dosage and need for adjuvant intervention after SWL for renal stones.

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Section: Introductionmentioning

confidence: 99%

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

Ahmed

Shalaby²,

El-Feky³

et al. 2016

Urol Int

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“…In a study by Singh et al [15], Visual Analogue Scale pain score in the Tamsulosin group was 24.92 ± 7.57 and in the control group was 41.81 ± 17.24, and the difference was statistically significant (P = 0.00). Hassan Ismail Mohamed showed that the mean cumulative Diclofenac dose was 380 mg/patient in the Tamsulosin group and 750 mg/patient in the control group and the difference was statistically significant (P = 0.004) [16]. We compared the requirement of the mean number of analgesic tablets in our study and found that the difference was significant between Groups A and C. We conclude that the use of Tamsulosin with Deflazacort can reduce most distressing symptoms of colic and associated with the decrease in requirement of analgesics.…”

Section: Requirement Of Analgesicsmentioning

confidence: 96%

“…In the control group, there were 8 (12%) complications, 4 with severe ureteric colic with the requirement of hospitalization and auxiliary procedure and another 4 with progressive hydronephrosis with fever. In the Tamsulosin group, 4 (6%) patients had fever with progressive hydronephrosis [16]. Bhagat et al [11] concluded that Tamsulosin improved the outcome of steinstrasse.…”

Section: Complicationsmentioning

confidence: 98%

“…In a study conducted on stone size 5-15 mm by Hassan Ismail Mohamed, stone free rate after 3 sessions of ESWL was 89% in the control group and 85% in the Tamsulosin group with no statistically significant difference (P = 0.34). He concluded that the use of Tamsulosin after ESWL did not improve success and stone free rates, but decreased the expulsion time [16]. Qadri et al analyzed and observed that the overall stone clearance rate in the control and Tamsulosin groups was 80.0% and 96.7% with statistically significant difference (P < 0.004).…”

Section: Stone Clearance Ratementioning

confidence: 99%

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Role of Tamsulosin with or without Deflazacort to facilitate stone clearance after ESWL: a single-center randomized controlled study

et al. 2020

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Background: Extracorporeal shock wave lithotripsy (ESWL) is the treatment of choice for upper tract calculi of moderate size. After ESWL, various factors affect the passage of small fragments through ureter like fragment's size and location. To facilitate fragment passage, a lot of medications have been tried and few have stood the test of the time. In this prospective study, we evaluated the role of Tamsulosin with or without Deflazacort versus no treatment after ESWL for ureteric and renal stones in terms of requirement of the number of ESWL sessions, stone clearance rate, stone expulsion time and analgesia requirements. Results:Patients presenting between age-groups of 18-70 years with solitary renal/ureteric calculus of size between 6 and 15 mm in major axis with Hounsfield unit less than 1000 were recruited in one of the three groups (A, B and C) randomly. Patients in Group A were prescribed Tamsulosin (0.4 mg once daily) with Deflazacort (30 mg once daily), Group B were given Tamsulosin (0.4 mg once daily), and Group C received no treatment (analgesics SOS and hydration therapy) after undergoing ESWL. Two hundred and twenty-five patients were recruited in Group A, and 240 patients were recruited in Group B and Group C each. There was an insignificant difference for required mean ESWL sessions and stone clearance rate between three groups. There was an early clearance of stone fragments in Group A than in Groups B and C, and it was statistically significant between Group A and Group C, specifically in the subgroup of stone size 10.1-15 mm. The requirement of mean analgesic tablets difference was significant between Groups A and C. Conclusions:Tamsulosin with Deflazacort decreases the number of required ESWL sessions and improves complete stone clearance, but the difference is not significant. There were significant improvement in facilitating early stone clearance and decrease in requirement of mean analgesic tablets after ESWL with Tamsulosin and Deflazacort. Thus, Tamsulosin with Deflazacort can be used safely to facilitate stone clearance without increased complication rate.

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“…Several randomized controlled trials (RCTs) studying the SFRs in different types of pharmacological therapy after ESWL have been reported 8 – 33 . However, most of these studies were designed to compare the clearance rates between one medication and control 8 – 10 , 12 , 13 , 15 – 20 , 22 – 32 . Moreover, in most studies, an arbitrary endpoint time was set to assess the stone clearance rate while ignoring possible variations of therapeutic effect before and after that endpoint time 8 – 14 , 18 , 19 , 21 , 23 , 25 , 26 , 28 , 29 , 31 – 33 .…”

Section: Introductionmentioning

confidence: 99%

A network meta-analysis on the beneficial effect of medical expulsive therapy after extracorporeal shock wave lithotripsy

Yang

Liao

Chen

et al. 2017

Sci Rep

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We applied a newly introduced method, network meta-analysis, to re-evaluate the expulsion effect of drugs including tamsulosin, doxazosin, nifedipine, terazosin and rowatinex after extracorporeal shock wave lithotripsy (ESWL) as described in the literature. A systematic search was performed in Medline, Embase and Cochrane Library for articles published before March 2016. Twenty-six studies with 2775 patients were included. The primary outcome was the number of patients with successful stone expulsion. The data were subdivided into three groups according to duration of follow-up. A standard network model was established in each subgroup. In 15-day follow-up results, SUCRA outcome showed the ranking of effects was: doxazosin > tamsulosin > rowatinex > nifedipine > terazosin (88.6, 77.4, 58.6, 32.2 and 30.4, respectively). In 45-day follow-up results, SUCRA ranking was: tamsulosin > nifedipine > rowatinex (69.4, 67.2 and 62.6, respectively). In 90-day follow-up results, SUCRA ranking was: doxazosin > rowatinex > tamsulosin (84.1, 68.1 and 49.1, respectively). In conclusion, doxazosin and tamsulosin have potential to be the first choice for pharmacological therapy to promote the expulsion of urinary stone fragments after ESWL, with this doxazosin can improve the SFR in the long term, while tamsulosin may result more in accelerating the process of expulsion.

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The efficacy of tamsulosin therapy after extracorporeal shock-wave lithotripsy for ureteric calculi: A prospective randomised, controlled study

Cited by 14 publications

References 26 publications

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

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

Role of Tamsulosin with or without Deflazacort to facilitate stone clearance after ESWL: a single-center randomized controlled study

A network meta-analysis on the beneficial effect of medical expulsive therapy after extracorporeal shock wave lithotripsy

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