Is there an adjunctive role of tamsulosin to extracorporeal shockwave lithotripsy for upper ureteric stones: results of an open label randomized nonplacebo controlled study

Abstract

Objectives: To investigate the role of tamsulosin as an adjunct to management of upper ureteric stones (UUS) with extracorporeal shock wave lithotripsy (SWL).

Methods: In this prospective, randomized, open label study, patients with single UUS (for SWL) were randomly assigned into 2 groups based on whether they received 0.4 mg tamsulosin (group A and B, respectively) during treatment. Repeat SWL was performed at week 1, 3, and 5 after first session. Primary outcome variables were success rate and pain intensity.

Results: A total of 40 patients (20 each group) completed the requisite follow-up. Success rate was higher in group A after 1 SWL-session (55% vs 25%, respectively; P = .05). There was an insignificant trend of decreased number of days (30.7 +/- 19.7 vs 39.0 +/- 19.9; P = .19), number of SWL sessions (1.6 vs 2.0; P = .10), and pain experienced (score on visual analog scale, 25.3 +/- 17.9 vs 38.3 +/- 28.0, respectively; P = .41) in group A. Three in group A and 6 in B developed steinstrasse (P = .69). Overall, 1 in group A required auxiliary procedures as compared with 3 in control group (P = .60).

Conclusions: Tamsulosin improves clearance rate of UUS after single SWL. However, it does not provide significant advantage in terms of decreasing pain associated with this treatment.