Publication:

Role of tamsulosin in patients undergoing ESWL for renal and ureteric stones

Background To determine the effect of tamsulosin, as adjunctive medical therapy on the outcome of extracorporeal shock wave lithotripsy (ESWL) for solitary renal and ureteric calculi.

Methods From January 2017 onwards, a prospective, randomized controlled study was conducted in patients with solitary renal or ureteral calculus measuring less than 20 mm undergoing ESWL. The study group (n=62) received 0.4 mg of tamsulosin daily till stone clearance or a maximum period of 12 weeks and control group (n=58) received ESWL only. Parameters assessed were stone size, composition, location, stone clearance, mean time to clearance, analgesic requirement, steinstrasse, need for hospitalization and/or auxiliary procedures.

Results There was no difference between the 2 groups with regards to age, stone size, location or composition. The complete clearance rate for renal stones was 62.7% and 36.5% (p=0.004) and for ureteric stone was 89.4% and 58.8% (p=0.03) in study and control groups, respectively. The control group had a higher rate of clinically insignificant residual fragments (CISF i.e. <3 mm), 12.9% versus 35.4% (p=0.002). There was no significant difference in the mean time to stone clearance (p=0.07) or in the incidence of steinstrasse formation (p=0.12). The mean analgesic requirement (p=0.01), need for auxiliary procedures and hospitalization (p=0.03) was significantly was higher in the control group.

Conclusions Tamsulosin increase the complete clearance rate and decrease the incidence of CISF. It also reduces analgesic requirement, need of additional procedures and hospitalization rate and might be useful as a routine adjunctive therapy following ESWL.