ABSTRACT
Aim: This study aims to compare the effect of tamsulosin versus placebo in the management of lower ureteric stones.Material and Methods: A total of 100 diagnosed patients of lower ureteric stone from the period of June 1, 2018, to May 31, 2019(12 months), were taken for the study. The study group was divided into three groups, Group A taken tamsulosin 0.4 mg + steroids(deflozacort 6 mg), Group B taken tamsulosin 0.4 mg + dicyclomine 20 mg, and Group C dicyclomine 20 mg alone. The results ofthree group were compared by expulsion rate and expulsion time of stones. Chi-square test was used for calculating the effect.Results: The mean age of Group A was 38.46 ± 10.68 years, Group B was 33.87 ± 9.62 years, and in Group C 32.94 ± 7.07 years.There was no significant relation between ages in stone expulsion. The mean calculus size in Group A was 5.93 ± 2.12 mm, Group Bwas 6.00 ± 2.03 mm, and Group C was 5.00 ± 2.01 mm. P = 0.784 was not statistically significant. In Group A, 40% of stones were onthe left side and 29.7% on the right side, in Group B, 20% of stones were on the left side and 40% on the right side, and in Group C,40% of stones were on the left side and 30.7% on the right side. P = 0.126 is not statistically significant. The mean time taken for stoneexpulsion in Group A was 5.39 ± 1.94 days, Group B was 4.75 ± 2.03 days, and Group C was 6.76 ± 1.90 days. P = 0.006 (<0.05)is highly statistically significant. Hence, in the present study, in Group A, 29 patients out of 33 patients, in Group B, 28 patients outof 33, and in Group C, 22 patients out of 34 patients, the stone was expelled out. P = 0.040 (<0.05) is highly statistically significant.There was no statistically significant difference which was found between the three groups in age, size, and side of stone.Conclusion: The results of this study have shown a potentially important role of tamsulosin for conservative expulsive therapyof distal ureteral stones, broadening pharmacological indications rather than endoscopic treatments for the resolution of thisdisease. Obviously, further studies with larger number of cases are necessary to validate these promising and statisticallysignificant results. The comparison with minimally invasive procedures in terms of cost and efficacy was useful, highlighting apredominant role of first-line pharmacological treatment, which can be easily be provided in an outpatient setting and not onlyat large, technologically advanced, centers. The drug tamsulosin proved to be safe and effective as demonstr ated by the lowincidence of side effects and the increased stone expulsion rate and reduced expulsion time. Moreover, medical expulsivetherapy with tamsulosin considerably decreased the analgesic use, thereby reducing additional need for pain relief and servedas an effective bridge between watch-and-wait management and surgical intervention.