efficacy of tamsulosin in lower reteral calculi

ABSTRACT

There has been a paradigm shift in the management of ureteral calculi in the last decade with the introduction of new less invasive methods, such as ureterorenoscopy and extracorporeal shock wave lithotripsy [ESWL]. Recent studies have reported excellent results with medical expulsive therapy [MET] for distal ureteral calculi, both in terms of stone expulsion and control of ureteral colic pain. We conducted a comparative study in between watchful waiting and MET with tamsulosin. We conducted a comparative study in between watchful waiting [Group I] and MET with tamsulosin [Group II] in 60 patients, with a follow up of 28 days. Independent 't' test and chi-square test. Group II showed a statistically significant advantage in terms of the stone expulsion rate. The mean number of episodes of pain, mean days to stone expulsion and mean amount of analgesic dosage used were statistically significantly in Group II [P value is 0.007, 0.01 and 0.007, respectively] as compared to Group I. It is concluded that MET should be considered for uncomplicated distal ureteral calculi before ureteroscopy extracorporeal lithotripsy. Tamsulosin has been found to increase and hasten stone expulsion rates, decrease acute attacks by acting as a spasmolytic, reduces mean days to stone expulsion and decreases analgesic dose usage