Prospective Randomized Trial Comparing Efficacy of Alfuzosin and Tamsulosin in Management of Lower Ureteral Stones
Received 21 March 2008; accepted 4 November 2008. published online 04 February 2009.
Objectives
To study the efficacy of alfuzosin compared with tamsulosin in the management of lower ureteral stones.
Methods
A total of 102 patients with stones <1 cm size and located in the lower ureter were enrolled in the present study and randomized into 3 equal groups. Group 1 patients (n = 34) received 0.4 mg tamsulosin daily, group 2 patients (n = 34) received 10 mg alfuzosin daily, and group 3 patients (n = 34) received placebo (control group). The patients were given 75 mg diclofenac injection intramuscularly on demand and were followed up for 4 weeks.
Results
The average stone size for groups 1, 2, and 3 was comparable (6.17, 6.70, and 6.35 mm, respectively). Stone expulsion was observed in 28 of 34 patients (82.3%) in group 1, 24 of 34 patients (70.5%) in group 2, and 12 of 34 patients (35.2%) in group 3. The average expulsion time for groups 1, 2, and 3 was 12.3, 14.5, and 24.5 days, respectively. The results of both study groups (groups 1 and 2) were superior to those in the placebo group (P = .003 and P = .001, respectively), but the study failed to show any statistically significant differences between tamsulosin and alfuzosin (P = .25). Alfuzosin was associated with fewer side effects than tamsulosin, especially in terms of retrograde ejaculation.
Conclusions
Medical treatment of lower ureteral calculi with tamsulosin and alfuzosin resulted in a significantly increased stone expulsion rate, decreased expulsion time, and a reduced need for analgesic therapy.
aDivision of Urology, Department of Surgery, S N Medical College, Agra, India
bDepartment of Surgery, S N Medical College, Agra, India
Reprint requests: Madhusudan Agrawal, M.Ch., Division of Urology, Department of Surgery, S N Medical College, 4/18c, Bagh Farzana, Civil Lines, Agra, Utter Pradesh 282002 India
ABSTRACT