Outcome of ureteric stone treatment with tamsulocin (original) (raw)
Related papers
Journal of Evolution of Medical and Dental Sciences, 2016
The urinary stone disease is one of the most common afflictions of the modern society and it has been described since antiquity with the westernization of global culture. The efficacy of mini-invasive therapies, such as Extracorporeal Shock Wave Lithotripsy [ESWL] and ureteroscopy are not risk free, are problematic and are quite expensive. Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitate stone expulsion. MATERIALS AND METHODS This prospective randomised study was conducted between September 2015 and May 2016 at Rajarajeshwari Medical College and Hospital, Bangalore. The cohort comprised 100 adult patients (54 men and 46 women) who presented with a symptomatic, unilateral, single, uncomplicated lower ureteric stone of ≤ 10 mm. Patients were randomized into two equal groups, 50 (50%) patients received a daily single dose of tamsulosin 0.4 mg for 28 days and 50 (50%) patients received a daily single dose of silodosin 8 mg for 28 days. Both groups were compared in terms of patient's demographics, socioeconomic status, stone size and side, type of MET, stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use and incidence of side effects. Subgroup analysis was performed according to stone size ≤ or > 5 mm.
THE AGE DISTRIBUTION AND EFFECTIVENESS OF LOW DOSE TAMSULOSIN IN LOWER URETERIC STONES
Objective: To determine the effectiveness of low dose tamsulosin as a medical expulsive therapy in patients with lower ureteric stones. Patients and Methods: The six months randomized control trial was conducted on all patients with either gender, age range 30-60 years and stone size 4-10 mm in the lower 1/3 rd of the ureter determined on ultrasound at tertiary care hospital. Group A patients was offered low dose tamsulosin (0.2 mg) one tablet daily in the morning for a maximum of 4 weeks and group B served as control. The final outcome was measured at the end of 4th week of treatment. Patients were instructed to note the time and the date of expulsion of stone. Absence of echoic shadows on lower 1/3rd of ureteric line on ultrasound was taken as effectiveness (expulsion of stone). Results: In control group mean age was 45.52 ±6.70 years whereas in low dose Tamsulin mean age was 46.72 ±6.73 years. Frequency of male was higher in both control and low dose Tamsulin group, i.e. 39 (78%) and 21 (42%) respectively. In control group effectiveness was found 3 (6%) patients whereas in low dose Tamsulin group effectiveness was found in 47 (94%). Conclusion: In our study the effectiveness of low dose tamsulosin as a medical expulsive therapy in patients with lower ureteric stones was higher as compared to control.
The Role of the Tamsulosin in the Medical Expulsion Therapy for Distal Ureteral Stones
Medical Archives
Background: This research aims to evaluate the role of tamsulosin in the medical expulsion therapy for distal ureteral stones, including her effects in stone expulsion time, expulsion rates, stone size, pain episodes and analgesic dosage usage. Material and methods: The 104 patients with distal ureteral calculi were examined, with the size of the stones 4-10 mm. They were randomly divided into two groups: study group (n=52), received tamsulosin 0.4 mg in morning, for 28 days, analgesic (diclofenac 75 mg), high fluid intake and Control group (n=52) received analgesic (diclofenac 75 mg), high fluid intake. Results: There is no significant difference between groups, based on sex (P=0.835) and age (P=0.987). Average size of the stones was 6.5 mm (SD ± 1.6 mm), with no significant difference (P=0.996). Stone expulsion rate is 90.4% in the study group and 71.2% from the control group, with statistical significance (P=0.023). The average time of the expulsion of stones in the study group was 9.6 days (SD ± 7.1 days), control group 13.7 days (SD ± 7.3 days), with statistical significance, (P=0.034). Average dose of analgesics in the study group was 63.7 mg (SD ± 45.2 mg), control group is 109.2 (SD ± 53.3), with statistical significance (P=0.019). Conclusion: Our study reveals that tamsulosin is efficient for the treatment of distal ureteral stones. Tamsulosin decrease the number of ureteral colic episodes, by acting as a spasmolytic, increase and hasten stone expulsion rates, reduce days of stone expulsion, decrease analgesic dose usage.
Arab Journal of Urology, 2013
Objectives: To assess and compare, in a randomised clinical trial, the efficacy of tamsulosin and nifedipine as medical expulsive therapy for distal ureterolithiasis. Patients and methods: In all, 128 symptomatic patients with stones in the juxtavesical tract of the ureter were randomly divided into group 1 (64 patients) receiving oral nifedipine sustained-release 30 mg/day, and group 2 (64 patients) receiving tamsulosin 0.4 mg/day. Both groups received oral prednisolone 30 mg/day for 10 days and diclofenac 75 mg intramuscularly on demand. Patients were assessed by weekly ultrasonography with or with no abdominal computed tomography, during a followup of 4 weeks. The stone passage rate and time, analgesic use, hospitalisation and endoscopic interventions were evaluated. The results were analysed statistically using appropriate tests. Results: The stone expulsion rate was 55% for group 1 and 80% for group 2 (P = 0.004). The mean stone size was 8.59 and 8.85 mm in groups 1 and 2, respectively. The mean expulsion time was 23 days for group 1 and 9 days for group 2 (P < 0.001). The mean number of diclofenac injections was 1.19 for group 1 and 0.42 for group 2 (P < 0.001). Eleven patients in group 1 vs. two in group 2 were
International Surgery Journal, 2016
Urolithiasis is a significant and worldwide health problem. Ureteral stones account for approximately 20% of urolithiasis cases. 70% of those cases are with location of stone in the distal 1/3 rd of ureter hence known as Distal Ureteral Stones (DUS) or Lower Ureteral Stones (LUS). Recently certain drugs have been used as supplement for observation in an effort to improve spontaneous stone expulsion. Tamsulosin and Silodosin are such selective alpha-blockers which act by relaxing the ureteral smooth muscles, richly innervated by alpha-adrenergic receptors. 1-4 Silodosin is a highly selective alpha 1A adrenoceptor blocker. Medical Expulsive Therapy (MET) is an excellent treatment modality in appropriately selected patients. Evidence suggests that MET can decrease colic events, narcotic usage and re-visits. MET also reduces unnecessary surgeries and associated risks thereby reducing cost of treatment. Despite the evidence, MET remains underutilized as a treatment modality. Factors influencing the spontaneous passage of ureteral stones are stone size, configuration, location, smooth muscle spasm, sub mucosal edema, and anatomy of lower ureter. We evaluated the efficacy of Tamsulosin and Silodosin as the medical treatment of symptomatic uncomplicated distal ABSTRACT Background: Alpha blockers are being commonly used as adjuvants in the medical management for the expulsion of ureteral stones. The present randomized study aims to evaluate the efficacy of Tamsulosin and Silodosin as medical therapy in the management of symptomatic distal ureteral stones. Methods: In this randomized control study the 120 patients enrolled were allotted to three groups. Patients in group 1 received tablet Tamsulosin 0.4 mg/day, group 2 received tablet Silodosin 8mg/day and group 3 served as the control group. Parameters noted were the blood pressure, stone position (% of expulsion in each group), adverse events noted and number of hospital visits. All patients were followed up weekly for a period of 28 days. Results: Study showed that both Tamsulosin (80% success) and Silodosin (85 %success rate) are equally efficacious when compared to the control group. Group 1 and Group 2 required less of pain killers and also had less frequent hospital admissions due to painful episodes as compared to the control group. Usual adverse reaction seen with alpha blockers like orthostatic hypotension and retrograde ejaculation were reported by some subjects in the test groups. Incidence of retrograde ejaculation was found to be more with the Silodosin group. Conclusions: Both the drugs appear to be effective in the medical management of distal ureteral stones. But Tamsulosin scores over Silodosin as it's well tolerated and with good stone expulsion rates.
Tamsulosin Hydrochloride vs Placebo for Management of Distal Ureteral Stones
Archives of Internal Medicine, 2010
Background: ␣-Blockers induce selective relaxation of ureteral smooth muscle with subsequent inhibition of ureteral spasms and dilatation of the ureteral lumen. The aim of the study was to evaluate the efficacy and safety of the ␣-blocker tamsulosin hydrochloride in patients with ureteral colic owing to a distal ureteral stone. Methods: This was a multicenter, placebo-controlled, randomized, double-blind study. Patients with emergency admission for ureteral colic with a 2-to 7-mmdiameter radio-opaque distal ureteral stone were included in the study. They received tamsulosin (0.4 mg/d) or matching placebo until stone expulsion or day 42, whichever came first. The main end point was time to stone expulsion between inclusion and day 42. Sequential statistical analysis was performed using the triangular test. Results: A total of 129 patients with acute renal colic were recruited from emergency wards between February 1, 2002, and December 8, 2006, in 6 French hospitals. Of these 129 randomized patients (placebo, 63; tamsulosin, 66), 7 were excluded from analyses: 5 for major deviations from inclusion criteria, 1 for stone expulsion before the first treatment administration, and 1 for consent withdrawal. At inclusion, mean (SD) stone diameters were 3.2 (1.2) and 2.9 (1.0) mm in the placebo and tamsulosin groups, respectively (P =.23). Expulsion delay distributions during 42 days did not show any difference (P =.30). The numbers of patients who spontaneously expelled their stone within 42 days were 43 of 61 (70.5%) and 47 of 61 (77.0%) in the placebo and tamsulosin groups, respectively (P=.41). Corresponding delays were 10.1 (10.0) and 9.6 (9.8) days (P =.82). Other secondary end points and tolerance were not different between groups. Conclusion: Although well tolerated, a daily administration of 0.4 mg of tamsulosin did not accelerate the expulsion of distal ureteral stones in patients with ureteral colic.
Tamsulosin Efficacy in Clearance of Lower Ureteric Stones
2019
Methods: 60 lower ureteric stones cases were selected for the study according to inclusion criteria. The demographic data of these cases were recorded as name, age and gender. The subjects who met the criteria of inclusion were divided randomly into two groups with a random number table. Group I (control) analgesia (diclofenac sodium 50 mg 12 hours) was given. Group II (study) was given 0.4 mg tamsulosin once a day for 28 days or until the spontaneous passage of the stone (the first one). Results: Stone excretion was observed in 11 of 30 patients in group I, and in group II, stone excretion was noted in 23 of 30 patients. The treatment in the 2 nd group showed significant results when compared to the stone extraction, group I, ie p = 0.0026. In group II; mean evacuation time was also lower significantly related to group I. Conclusion: The small distal ureteral stones were spontaneously excreted by the Alpha 1 antagonist (tamsulosin).
Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin
Archivio Italiano di Urologia e Andrologia, 2014
Objectives: To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET) of distal ureteric stones. Patients and methods: Observational data were collected retrospectively from patients who received silodosin (N = 50) or tamsulosin (N = 50) as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Results: Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant). Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant). Mean number of pain episodes we...