Does tamsulosin increase stone clearance after shockwave lithotripsy of renal stones? A prospective, randomized controlled study

Abstract

Objective. To evaluate the efficacy of the selective α-blocker tamsulosin on stone clearance after shockwave lithotripsy (SWL) of renal stones. Material and methods. A prospective, randomized, controlled study was carried out in 166 patients who underwent SWL for renal stones between January and December 2007. Group 1 (n = 83) took tamsulosin 0.4 mg once daily and diclofenac sodium injection (75 mg) on demand. Group 2 (n = 83) took only diclofenac sodium as needed. Patients were on this regimen for 4 weeks or until stone clearance and were followed up for a maximum of 3 months. They were evaluated for stone clearance, time to stone clearance, colic attacks, need for analgesics and any side-effects at 2 weeks, and 1, 2 and 3 months. Results. In total, 136 patients (67 in group 1 and 69 in group 2) were available for evaluation. The demographic profile was comparable in both groups. Group 1 had a clearance rate of 73% (49/67) versus 55% (38/69) in group 2 (p = 0.008). Time to stone clearance was significantly different at 1, 2 and 3 months (p = 0.02, 0.01 and 0.008, respectively), but not significant at 2 weeks (p = 0.52). In group 2, higher number of patients had more frequent attacks of colic and used more analgesics than in group 1 (p = 003, 0.001 and 0.002, respectively). Nine patients (13.4%) in group 1 had ejaculatory dysfunction. Conclusions. Tamsulosin significantly increases stone clearance after SWL of renal stones. It decreases the pain and amount of analgesics needed, with a low rate of side-effects.

Key Words::

• α-Adrenergic antagonists
• lithotripsy
• renal stones

Acknowledgements

We would like to thank Dr Ahmed F. Hamed, Department of Public Health and Statistics, for his statistical assistance and Ms Soad Fathy for her technical help.

Conflict of interest statement

Declaration of interests: No funding was received.