Role of Tamsulos
Role of Tamsulosin Oral Control Absorption System and Alfuazocin in Shock wave Lithotripsy for Renal and Upper Ureteric Calculi
Yasser A. Badran, Tamer A. Ali, Mohamed A. Abd Elaal, Mahmud Ali, Adil Jamal and Ahmed Farouk Abdulall
Departments of Urology, Al-Azhar University, Cairo, Egypt and Soliman Fakeeh Hospital, Jeddah, KSA
Abstract: Objectives: - To evaluate the effect of tamsulosin oral controlled absorption system 0.4 mg and alfuzosin 10 mg on clearance of stone fragments after ESWL in renal and upper ureteric calculi. Patients and Methods: - A total of 200 patients with single pelvic renal or upper ureteric calculi 20 mm or less were enrolled in this study, underwent ESWL, those patient were divided into 3 groups, group (A) formed of 65 patients received non steroidal anti inflammatory in the form of diclofinac Na 50 mg three times /day on demand with tamsulosin oral controlled absorption system 0.4 mg once daily. Group (B) formed of 66 patients receiving diclofinac Na 50 mg three times /daily on demand with alfuzosin 10 mg at night on bed time. Group (C) formed of 69 patients received diclofinac Na 50 mg three times /daily on demand as controlled group. All groups received 75 mg of diclofinac Na ampule intramuscular on demand. All patients were followed by KUB 2 weeks after each session of ESWL for clearance of stone fragments; all groups are comparable as regard of age, sex mean stone size and stone location. Results: - In our study the success rate after the end of study for stone size 10 mm or less was 28/28 patients 100% in group (A), 31/31 patients 100% in group (B) and 28/30 patients 93.3% in group (C). For stone size more than 10 mm, the success rate after 1st session of ESWL was higher in group (A) 26/37 patients 70.27% tamsulosin oral controlled absorption system and group (B) 25/35 patients 71.4% extended release alfuzosin10 mg than group (C) 17/39 patients 35.89% controlled group. The overall success rate at end of study was higher in group (A) 36/37 patients 97.29% and group (B) 33/35 patients 94.28% than group (C) 31/39 patients 79.48%. No sever complication was observed in three groups A,B and C, retrograde ejaculation was 7.69% (5 patients) in group A, orthostatic hypotension did not require suspension of the therapy was 3% (2 patients) in group A and 6% (4 patients) in group B. Conclusion: - Medical expulsive therapy (tamsulosin oral controlled absorption system 0.4 mg) and alfuzosin 10 mg after ESWL for renal and ureteral calculi >10 mm increase stone expulsion rate, decrease the time for stone expulsion, amount of analgesia and number of colics episodes,in contrast,alpha blocker failed to demonstrate a significant treatment effect after ESWL for stone less than 10 mm.
[Yasser A. Badran, Tamer A. Ali, Mohamed A. Abd Elaal, Mahmud ali, Adil Jamal and Ahmed Farouk Abdulall.Role of Tamsulosin Oral Control Absorption System and Alfuazocin in Shock wave Lithotripsy for Renal and Upper Ureteric Calculi. J Am Sci 2013;9(6):387-393]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 46
Keywords: Tamsulosin. ESWL, Stones