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    Korean J Urol. 2006 Jul;47(7):708-711. Korean.
    Published online Jul 31, 2006.
    https://doi.org/10.4111/kju.2006.47.7.708
    Copyright © 2006 The Korean Urological Association
    Original Article

    Effect of Tamsulosin on the Expectant Treatment of Lower Ureteral Stones

    Min Cheol Han, Young Yo Park and Bong Suk Shim
      • Department of Urology, College of Medicine, Ewha Womans University, Seoul, Korea.
    • Corresponding author (Email: bonstone@ewha.ac.kr )
    Received April 03, 2006; Accepted May 24, 2006.

    Abstract

    Purpose

    We evaluated the effectiveness of tamsulosin on the expectant treatment for the patients suffering with lower ureteral stones.

    Materials and Methods

    A total of 67 patients with stones less than 5mm that were located in the lower ureter were enrolled in the study. The patients were randomly divided into two groups. Group 1 (n=32) received 20mg caroverine (a spasmolytic drug) orally three time a day. Group 2 (n=35) received 0.2mg tamsulosin orally one time a day. The treatment was continued until expulsion of stone or to a maximum of 28 days. All patients were allowed 30mg ketorolac trimethamine intramuscular injections on demand. We compared the two groups for stone size, the expulsion rate, the time to expulsion and use of analgesics.

    Results

    The average stone size was 4.3±0.61mm for group 1 and 4.4±0.51mm for group 2. No statistical difference between two groups was found for stone size, age and sexual distribution. The expulsion rate was significantly higher in group 2 (82.8%), compared with group 1 (53.1%) (p=0.002). The mean expulsion time was 8.3 days for group 1 and 4.6 days for group 2 (p<0.0001). The average number of intramuscular analgesic injections was 3.9 for group 1 and 1.1 for group 2 (p<0.0001).

    Conclusions

    Tamsulosin was proved to be effective and safe, as demonstrated by the increased stone expulsion rate, the decreased expulsion time and the reduced use of pain control in the expectant treatment of the lower ureter stones.

    Keywords
    Urinary calculi; Treatment; Tamsulosin

    Figures

    Fig. 1
    Comparison of stone size between the expulsion patients and no expulsion patients in both groups. No statistically significant difference is found for stone size. p-values are determined using chi-square testing.

    Tables

    Table 1
    Patient characteristics at baseline

    Table 2
    Comparison of the results according to the treatment modality

    References

      1. Carstensen HE, Hansen JS. Stones in ureter. Acta Chir Scand 1973;433:66–70.
      1. Kupeli B, Biri H, Isen K, Onaran M, Alkibay T, Karaoglan U, et al. Treatment of ureteral stones: comparison of extracorporeal shock wave lithotripsy and endourologic alternatives. Eur Urol 1998;34:474–479.
      1. Kim KH, Shim BS. The comparison of efficacy of ureteroscopic removal and shockwave lithotripsy in lower ureteral stones. Korean J Urol 2001;42:905–909.
      1. Hochreiter WW, Danuser H, Perrig M, Studer UE. Extracorporeal shock wave lithotripsy for distal ureteral calculi: what a powerful machine can achieve. J Urol 2003;169:878–880.
      1. Menon M, Resnick MI. Urinary lithiasis: etiology, diagnosis, and medical management. In: Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ, editors. Compbell's urology. 8th ed. Philadelphia: Saunders; 2002. pp. 3227-3292.
      1. Cervenakov I, Fillo J, Mardiak J, Kopecny M, Smirala J, Lepies P. Speedy elimination of ureterolithiasis in lower part of ureters with the alpha1-blocker tamsulosin. Int Urol Nephrol 2002;34:25–29.
      1. Danuser H, Weiss R, Abel D, Walter B, Scholtysik G, Mettler D, et al. Systemic and topical drug administration in the pig ureter: effect of phosphodiesterase inhibitors alpha1, beta and beta2-adrenergic receptor agonists and antagonists on the frequency and amplitude of ureteral contractions. J Urol 2001;166:714–720.
      1. Peters HJ, Parekh N, Popa G. Effect of adrenergic and cholinergic agents on ureteral functions in dogs. Urol Int 1979;34:137–146.
      1. Hancock AA. α1-Adrenoceptor subtypes: a synopsis of their pharmacology and molecular biology. Drug Dev Res 1996;39:54–107.
      1. Zhong H, Minneman KP. α1-adrenoceptor subtypes. Eur J Pharmacol 1999;375:261–276.
      1. Porpiglia F, Destefanis P, Fiori C, Fontana D. Effectiveness of nifedipine and deflazacort in the management of distal ureteral stones. Urology 2000;56:579–582.
      1. Stoller ML, Bolton DM. Urinary stone disease. In: Tanagho EA, Mcaninch JW, editors. Smith's urology. 15th ed. New York: Mc Graw-Hill; 2000. pp. 291-320.
      1. Hubner WA, Irby P, Stoller ML. Natural history and current concepts for the treatment of small ureteral calculi. Eur Urol 1993;24:172–176.
      1. Porpiglia F, Ghignone G, Fiori C, Fontana D, Scarpa RM. Nifedipine versus tamsulosin for the management of lower ureteral stones. J Urol 2004;172:568–571.
      1. Hussain Z, Inman RD, Elves AW, Shipstone DP, Ghiblawi S, Coppinger SW. Use of glyceryl trinitrate patches in patients with ureteral stones: a randomizes, double-blind, placebo-controlled study. Urology 2001;58:521–525.
      1. Shoekeir AA. Renal colic: pathophysiology, diagnosis and treatment. Eur Urol 2001;39:241–249.
      1. Porpiglia F, Destefanis P, Fiori C, Scarpa RM, Fontana D. Role of adjunctive medical therapy with nifedipine and deflazacort after shock wave lithotripsy of ureteral stones. Urology 2002;59:835–838.
      1. Malin JM Jr, Deane RF, Boyarsky S. Characterization of adrenergic receptors in human ureter. Br J Urol 1970;42:171–174.
      1. Morita T, Ando M, Kihara K, Oshima H. Function and distribution of autonomic receptors in canine ureteral smooth muscle. Neurourol Urodyn 1994;13:315–321.
      1. Obara K, Takeda M, Shimura H, Kanai T, Tsutsui T, Komeyama T, et al. Alpha-1 adrenoreceptor subtypes in the human ureter: characterization by RT-PCR and in situ hybridization. J Urol 1996;155 Suppl:472A.
        abstract 646.
      1. Morita T, Wada I, Saeki H, Tauchida S, Weiss RM. Ureteral urine transport: changes in bolus volume, peristaltic frequency, intraluminal pressure and volume of flow resulting from autonomic drugs. J Urol 1987;137:132–135.
      1. Dellabella M, Milanese G, Muzzonigro G. Efficacy of tamsulosin in the medical management of juxtavesical ureteral stones. J Urol 2003;170:2202–2205.
      1. Resim S, Ekerbicer H, Ciftci A. Effect of tamsulosin on the number and intensity of ureteral colic in patients with lower ureteral calculus. Int J Urol 2005;12:615–620.
      1. Dellabella M, Milanese G, Muzzonigro G. Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. J Urol 2005;174:167–172.
      1. O'Leary MP. Tamsulosin: current clinical experience. Urology 2001;58 Suppl 6A:42–48.
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    MeSH Terms
    Analgesics
    Humans
    Injections, Intramuscular
    Ketorolac
    Ureter*
    Urinary Calculi
    Metrics
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