The role of tamsulosin administration in evolution of stone clearence after shock wave lithotripsy for ureteral stones

Abstract

Introduction. Management of symptomatic ureteric stones still represents the most common condition in urological practice. ESWL, a noninvasive technology, has become one of the main active interventions for ureteral stones; its success depends on stone size and location, and the type of lithotripter. Expulsion therapy of the stone requires ureteric peristalsis, tamsulosin must be the first as an adjunctive medical therapy after ESWL, is more effective for the treatment of patients with ureteral stones. Aim of the study. To determine whether the administration of tamsulosin, as a medical therapy, increases the stone clearance after extracorporeal shock wave lithotripsy (ESWL). Materials and methods. A total of 250 patients underwent a single ESWL session to treat ureteral stone up to 15 mm in diameter. After ESWL patients were randomized in two groups. Group A (control) – 125 patients were administered non-steroidal anti-inflammatory drugs. In group B, 125 patients additionally were prescribed tamsulosin 400 mg daily. Follow-up visits were performed once per week for 4 weeks after ESWL. Evaluation included a KUB plain film and an ultrasound examination. Efficacy was evaluated in terms of success rate, stone-free rate, expulsion time of the fragments and use of tamsulosin. Results. The success rate was for the control group was 65 % and the tamsulosin group was 80 %, respectively. The mean expulsion time of the fragments was 10.2 days for group A and 8 days for group B. The stone-free rate in group A was 67 % and in group B – 87%. Conclusions. The results of our study have demonstrated that tamsulosin therapy, as an adjuvant medical therapy after ESWL, is more effective for the treatment of patients with ureteral stone up to 15 mm.