[ effects of tamsulosin versus indomethacin in the expulsion of the lower urethral stones]

ABSTRACT

Urinary stones are among the most prevalent urological diseases [1-15%]. While passing from kidneys to bladder, these stones stay in the lower urethra, causing painful spasms. Watchful waiting method [between 1-6 weeks] is one of the most common remedies in the treatment of lower urethral stones on the other hand, alpha-receptors, which help with controlling the spasm, exist in the distal urethras, especially in the trigone of the bladder. So, we decided to study the effects of Tamsulosin [alpha-blockers], as compared to Incomethacin, on patients suffering from distal urethral stones. The objective of this study is to evaluate the effect of alpha-blocker [Tamsulosin] on the expulsion of lower urethral stones in the patients who referred to Bahman 22nd and Aria hospitals in one year. 85 patients who were diagnosed as suffering from urethral stones were randomly divided into 2 groups. 46 patients who were placed in the first group received Tamsulosin [0.4 mg/daily] with suppository of Indomethacin for 10 days. The other 39 patients in the second group received only Indomethacin. After taking the prescribed medicines, the patients were again examined and controlled by KUB and Ultrasound. Then, the results were compared using statistical analysis. 32 of the patients in the first group [the case] who had received Tamsulosin had stone expulsion while the other 14 patients did not. Among the patients in the control group [a total of 39], 22 patients had stone expulsion while 17 patients did not. The result of chi-square test revealed that the 2 groups were not significantly different from each other in terms of stone expulsion and prognosis [P=0.209]. There were no statistical differences between the groups of study according to age, gender and the stone size, either. According to these findings, we do not suggest the prescription of Tamsulosin as an adjuvant therapy for stone expulsion in patients who have lower ureteral stone without considering their stone size and gender. Instead, just prescribing pain relief [if necessary] and physical activity with large amount of oral liquid intake during the watchful waiting period are enough