Literature DB >> 18799202

Tamsulosin facilitates earlier clearance of stone fragments and reduces pain after shockwave lithotripsy for renal calculi: results from an open-label randomized study.

Vineet Naja1, Mayank Mohan Agarwal, Arup K Mandal, Shrawan K Singh, Ravimohan Mavuduru, Santosh Kumar, Naveen C Acharya, Nitin Gupta.   

Abstract

OBJECTIVES: To evaluate the role of tamsulosin in the clearance of fragments after extracorporeal shock wave lithotripsy (ESWL) to treat renal calculi.
METHODS: In this open-label prospective randomized study conducted at our institute from 2006 to 2007, 139 patients with normal renal function and a single radiopaque renal calculus, 5-20 mm, undergoing ESWL were enrolled. All patients underwent ESWL every 3 weeks until success or for <or=3 months, whichever was earlier. They were randomly assigned to 2 groups with respect to whether they had received tamsulosin, 0.4 mg/d. The primary endpoint was the success rate, and the secondary endpoints were clearance time, sessions required for clearance, pain intensity, incidence of steinstrasse, and the need for auxiliary procedures.
RESULTS: Of the 139 patients, 51 in group 1 and 65 in group 2 completed the requisite follow-up. The demographic profile of both groups was comparable. The success rate after 1, 2, and 3 ESWL sessions was greater in group 1 than in group 2 (52.9%, 78.4%, and 94.1% vs 30.8%, 52.3%, and 75.4%; P = .016, P = .004, and P = .007, respectively). The total days required for success (35.53 +/- 19.47 vs 47.22 +/- 23.64; P = .006), total ESWL sessions required for success (1.66 vs 2.16; P = .005), and the pain experienced (visual analog scale score 28.67 +/- 20.35 vs 47.30 +/- 24.98, respectively; P = .0001) were significantly less in group 1. Two patients in group 1 and 9 in group 2 developed steinstrasse (P = .10); conservative management was successful in 1 patient in each group (P = .345). Three patients in group 1 and 10 in group 2 required auxiliary procedures (P = .14).
CONCLUSIONS: The results of our study have shown that tamsulosin facilitates earlier clearance of fragments after ESWL to renal calculi and helps reduce the severity of the pain. It tended to facilitate spontaneous clearance of steinstrasse; however, this requires additional evaluation.

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Year:  2008        PMID: 18799202     DOI: 10.1016/j.urology.2008.05.035

Source DB:  PubMed          Journal:  Urology        ISSN: 0090-4295            Impact factor:   2.649


  15 in total

Review 1.  Aspects on how extracorporeal shockwave lithotripsy should be carried out in order to be maximally effective.

Authors:  Hans-Göran Tiselius; Christian G Chaussy
Journal:  Urol Res       Date:  2012-06-27

2.  Tamsulosin and doxazosin as adjunctive therapy following shock-wave lithotripsy of renal calculi: randomized controlled trial.

Authors:  Osama M Zaytoun; Rachid Yakoubi; Abdel Rahman M Zahran; Khaled Fouda; Essam Marzouk; Salah Gaafar; Khaled Fareed
Journal:  Urol Res       Date:  2011-08-12

3.  CUA Guideline: Management of ureteral calculi.

Authors:  Michael Ordon; Sero Andonian; Brian Blew; Trevor Schuler; Ben Chew; Kenneth T Pace
Journal:  Can Urol Assoc J       Date:  2015-12-14       Impact factor: 1.862

4.  Efficacy of Adjuvant Tamsulosin for Improving the Stone-Free Rate after Extracorporeal Shock Wave Lithotripsy in Renal Stones: A Randomized Controlled Trial.

Authors:  Rafael Edgardo Maldonado-Valadez; Angel David Valdez-Vargas; José Antonio Alvarez; Edel Rafael Rodea-Montero
Journal:  Int J Clin Pract       Date:  2022-01-31       Impact factor: 3.149

5.  Can the Hounsfield unit predict the success of medically expulsive therapy?

Authors:  Sakip Erturhan; Omer Bayrak; Ahmet Mete; Ilker Seckiner; Gokhan Urgun; Kemal Sarica
Journal:  Can Urol Assoc J       Date:  2013 Nov-Dec       Impact factor: 1.862

6.  Shock-wave lithotripsy: variance within UK practice.

Authors:  N L Sharma; C E Alexander; E Grout; B W Turney
Journal:  Urolithiasis       Date:  2016-05-23       Impact factor: 3.436

Review 7.  Complications of extracorporeal shock wave lithotripsy for urinary stones: to know and to manage them-a review.

Authors:  Alessandro D'Addessi; Matteo Vittori; Marco Racioppi; Francesco Pinto; Emilio Sacco; PierFrancesco Bassi
Journal:  ScientificWorldJournal       Date:  2012-03-12

8.  Adjunctive medical therapy with α-blocker after extracorporeal shock wave lithotripsy of renal and ureteral stones: a meta-analysis.

Authors:  Mingchao Li; Zhengyun Wang; Jun Yang; Xiaolin Guo; Tao Wang; Shaogang Wang; Chunping Yin; Jihong Liu; Zhangqun Ye
Journal:  PLoS One       Date:  2015-04-10       Impact factor: 3.240

9.  The efficacy of tamsulosin therapy after extracorporeal shock-wave lithotripsy for ureteric calculi: A prospective randomised, controlled study.

Authors:  Hassan Ismail Mohamed
Journal:  Arab J Urol       Date:  2013-09-29

10.  Alpha-blockers after shock wave lithotripsy for renal or ureteral stones in adults.

Authors:  Makinna C Oestreich; Robin Wm Vernooij; Niranjan J Sathianathen; Eu Chang Hwang; Gretchen M Kuntz; Alex Koziarz; Charles D Scales; Philipp Dahm
Journal:  Cochrane Database Syst Rev       Date:  2020-11-12
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