Evaluation On The Efficacy Of Tamsulosin For The Management Of Distal Ureter Stones

Objective: To evaluate the efficacy of alpha-blockers (Tamsulosin) for theadjunctive expulsive therapy in patients with lower ureteral stonesMethods: A total of 128 patients with stones located an the distal 7mm of theureter were divided into four groups. Group A consisted of 62 patients withstones less than 7mm were randomly divided into two subgroups (31casesin each group).Group a₁ served as controls; Group a₂ receiced tamsulosin(0.4mg, once daily).Group B consisted of 66 patients with stones greaterthan 7mm who underwent extracorporeal shock wave lithotripsy(ESWL).These patients were also randomly divided to those who did no(group b₁ ,n=32) and those who did (group b₂, n=34) receive tamsulosin0.4mg daily.Results: Of the 128 patients, 85(66.4%) became stone free. The stone-free rate was45.2%, 77.4%, 56.3% and 85.3% for group a₁, a₂, b₃ and b₄ respectively.The difference between the stone-free rates for groups a₁ versus a₂(P=0.009) and groups b₁ versus b₂(P=0.000).The mean expulsion time ofgroup a₁, a₂, b₁ and b₂ was 8, 3.5, 5 and 3d, respectively, with significantdifference between groups a₁ versus a₂ (P=0.001) and groups b₁ versus b₂(P=0.001). In groups a₁, a₂, b₁ and b₂,renal colic recurred within 2 weeksand analgesics were used in 8 cases, 1, 5 ,and 0, respectively ,withsignificant difference between the groups a₁ versus a₂ (P=0.031) and b₁versus b₂ (P=0.017). All the patients tolerated the expulsive therapy and no one withdrew from treatment. No obvious side effect of Tamsulosinoccurred.Conclusions: The addition of Tamsulosion to conventional treatments was safeand effective in terms of stone clearance of lower ureteral stones .It cansignificantly improve the stone expulsion rate.