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KMID : 0358320070480070724
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Korean Journal of Urology
2007 Volume.48 No. 7 p.724 ~ p.730
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Effect of Tamsulosin on the Expected Treatment of Upper and Lower Ureteral Stones
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Kim Jin-Wook
Cho Dae-Youn
Lee Jeong-Gu
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Abstract
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Purpose: We evaluated the effect of tamsulosin on upper and lower ureteral stones that were smaller than 10mm to identify the patient groups for which tamsulosin was most applicable.
Materials & Methods: 85 patients who were diagnosed with ureteral stones smaller than 10mm in size were enrolled in this randomized prospective study. The patients were diagnosed via intravenous pyelography and then they were followed with weekly plain abdomen films for 4 weeks. The control group(Group 1) was given an nonsteroidal antiinflammatory drug(NSAID) for pain medication, and they were instructed to ingest at least 2l of fluids daily. For the treatment group(Group 2) once daily 0.2mg tamsulosin was added. Both groups were compared for the size of stone and the days to expulsion and pain control, based upon the number of emergency room(ER) visits. The proximal and distal ureteral stones were separately evaluated, and the patients’ gender, age, stone size and stone position were analyzed to identify treatment efficacy.
Results: The average stone size was 5.2±2.6mm in group 1 and 4.7±1.5mm in group 2(p=0.344). The success rate was 42.9% in group 1 and 76.5% in group 2(p=0.005). Group 2 showed a significant reduction for the time to stone expulsion at 12.7±6.6 days compared to 18.5±6.9 days for group 1(p=0.008). Among the subset of patients, those with distal ureteral stones smaller than 5mm alone showed a significant increase in the expulsion rate(100%, p=0.047) and a decrease of the days to expulsion(12.1±5.1 days, p=0.018).
Conclusion: Tamsulosin increases the spontaneous expulsion rate and reduces the time to expulse ureteral stones, and it was most effective for distal stones less than 5mm in size. (Korean J Urol 2007;48:724-730)
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KEYWORD
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Urinary calcul, Treatment, Tamsulosin
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