Is There an Adjunctive Role of Tamsulosin to Extracorporeal Shockwave Lithotripsy for Upper Ureteric Stones: Results of an Open Label Randomized Nonplacebo Controlled Study
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Mayank Mohan Agarwal, Arup K. Mandal, Shrawan K. Singh
Urology
November 2009 (Vol. 74, Issue 5, Page 993) Full Text |
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Objectives
To investigate the role of tamsulosin as an adjunct to management of upper ureteric stones (UUS) with extracorporeal shock wave lithotripsy (SWL).
Methods
In this prospective, randomized, open label study, patients with single UUS (for SWL) were randomly assigned into 2 groups based on whether they received 0.4 mg tamsulosin (group A and B, respectively) during treatment. Repeat SWL was performed at week 1, 3, and 5 after first session. Primary outcome variables were success rate and pain intensity.
Results
A total of 40 patients (20 each group) completed the requisite follow-up. Success rate was higher in group A after 1 SWL-session (55% vs 25%, respectively; P = .05). There was an insignificant trend of decreased number of days (30.7 ± 19.7 vs 39.0 ± 19.9; P = .19), number of SWL sessions (1.6 vs 2.0; P = .10), and pain experienced (score on visual analog scale, 25.3 ± 17.9 vs 38.3 ± 28.0, respectively; P = .41) in group A. Three in group A and 6 in B developed steinstrasse (P = .69). Overall, 1 in group A required auxiliary procedures as compared with 3 in control group (P = .60).
Conclusions
Tamsulosin improves clearance rate of UUS after single SWL. However, it does not provide significant advantage in terms of decreasing pain associated with this treatment.
Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
Reprint requests: Arup K. Mandal, M.S., M.Ch., Department of Urology, Level II, B Block, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh, India. PIN 160012
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