Role of a-blockers as adjunctive therapy folowing schok-wave litotripsy of renal calculi

Abstract

Introduction: It was demonstrated the effectiveness of the a-blockers for medical expulsion therapy in urolithyasis. We aimed to assess the effect of Tamsulosin adjunctive therapy following ESWL for renal calculi. Methods: In prospective study were included 49 patients who underwent ESWL therapy for renal stones (> 1,5cm) from May 2011 to 2012. Patients were randomized into two groups. Group I (tamsulosin group) - 29 patients received standard therapy + Proflosin’ (Berlin-Chemie/Menarini) 0,4 mg once a day, Group II (control group) - 20 patients received standard therapy only. Patients were evaluated for stone expulsion, colic attacks, amount of analgesics and side-effects. Results: The groups were comparable for age, gender and stone size. Mean patients’ age was 48,3±13 years (Mean±SD). There were 25 females and 24 males. Mean stone size was 1,56±0,14 cm (MeantSD). There was no significant difference between the groups regarding stone expulsion rates, in Group I it was 93,1% (27/29) and in Group II - 90,0% (18/20). The mean expulsion time (Mean±SE) in Group I (5,2±0,8 days) was shorter than in Group II (7,8±1,0 day), and this difference was statistically significant (p<0,05). Both number of colic episodes and analgesics dosage were significantly lower with Tamsulosin as compared to control group. Steinstrasse was encountered in 6,1% (3/49) of patients with no significant difference between groups. The 31,0% (9/29) of patients in tamsulosin group experienced side effects related to postural hypotension. One patient in the Tamsulosin group reported ejaculatory complaints. No patient in Group I was not interrupted the therapy because of side-effects. Conclusions: Adjunction of Proflosin' after the ESWL for renal calculi decrease the time for stone fragments expulsion, amount of the analgesics and number colic episodes. The side-effects of Proflosin demonstrated no clinically significant.