STONE-FREE RATE DIFFERENCES IN KIDNEY STONES PATIENTS WITH AND WITHOUT TAMSULOSIN AFTER ESWL
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Abstract
Objective: To determine whether the administration of tamsulosin, as adjunctive medical therapy, increases the efficacy of one session of extracorporeal shock wave lithotripsy (ESWL) to treat renal stones. Material & Method: A prospective randomized placebo controlled study enrolled 21 patients. They underwent a single ESWL session to treat solitary radiopaque renal stones 4 to 20 mm in diameter. After ESWL, the study group (11) received 0,4 mg tamsulosin daily and the control group (10) received placebo until stone clearance or a maximum period of 8 weeks. The primary endpoint was stone-free rate and parameters were stone size and clearance time. Results: The overall stone-free rate was better in the study group than in the control group (90,9% vs. 60,0%). The clearance time after 2, 4, 6 and 8 weeks was greater in the study group than in the control group (36,4%; 63,6%; 72,7% and 90,9% vs 30,0%; 50,0%; and 60,0% respectively) but statistically insignificant. Conclusion: Clinically, the results of our study have demonstrated that tamsulosin therapy, as an adjunctive medical therapy after ESWL, is more effective than lithotripsy alone for the treatment of patients with renal stones. Keywords: ESWL, tamsulosin, medical expulsive therapy, renal stones.
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Marshall LS, Damien MB. Urinary stone disease. In: Smith’s General Urology. 15th ed. The McGraw-Hill Companies: New York; 2000. p. 291-320.
Margaret L, Pearle S, Yair L. Urinary lithiasis: Etiology, epidemiology, and pathogenesis. In: Campbell-Walsh Urology. 9th ed. Saunders; Toronto.
Rochani Sumardi. Guidelines penatalaksanaan penyakit batu saluran kemih; 2007. p. 1-45.
Rasweiller JJ, Renner C, Eisenberger F. The management of complex renal stones. BJU Int 2000; 86: 919-28.
Ravi M, Glenn MP. Urinary tract stones. In: Comprehensive Urology. Mosby: London; 2001. p. 313-32.
Bush WH, Jases D, Gibbons RP. Radiation dose to patient and personnel during ESWL. J Urol 1987; 138: 716-9.
Michael Grasso. Extracorporeal shockwave lithotripsy; 2007: 42. Last update 2008 http://www.emedicine.com/med/TOPIC3024.HTM
Kűpeli B, Irkilata L, Gűrocak S, Tunç L, Kiraç M, Karaoğlan U, et al. Does tamsulosin enhance lower ureteral stone with or without shock wave lithotripsy? Urology 2004; 65: 1111-5.
Gravina GL, Costa AM, Ronchi P, Galatioto GP, Angelucci A, Castellani D, et al. Tamsulosin treatment increases clinical success rate of single extracorporeal shock wave lithotripsy of renal stones. Urology 2005; 66: 24-8.
Pearle MS, Calhoun EA, Curhan GC. Urologic diseases in America project: Urolithiasis. J Urol 2005; 173: 848-57.
Seitz C, Liatsikos E, Porpiglia F, Tiselius HG, Zwergel U. Medical therapy to facilitate the passage of stones: What is evidence? Eur Urol 2009; 56: 455-71.
Bhagat SK, Chacko NK, Kekre NS, Gopalakrishnan G, Antonysami B, Devasia A. Is there a role for tamsulosin in shock wave lithotripsy for renal and ureteral calculi? J Urol 2007; 177 (6): 2185-8.
Naja V, Agarwal MM, Mandal AK, Singh SK, Mavuduru R, Kumar S, et al. Tamsulosin facilitates earlier clearance of stone fragments and reduces pain after shockwave lithotripsy for renal calculi: Results from an open label randomized study. Urology 2008; 72 (5): 1006-11.
Augustin H. Prediction of stone free rate after ESWL. Eur Urol 2007; 52: 318-20.
Sampaio FJ, D’Anunciacao AL, Silva EC. Comparative follow up of patients with acute and obtuse infundibulum-pelvic angle submitted to extracorporeal shock wave lithotripsy for lower caliceal stones: Preliminary report and proposed study design. J Endourol 1997; 11: 157-61.
Sorensen CM, Chandoke PS. Is lower pole caliceal anatomy predictive of extracorporeal shock wave lithotripsy success for primary lower pole kidney stones? J Urol 2002; 168: 2377-82.
Danuser H, Muller R, Descoeudres B, Dobry E, Studer UE. Extracorporeal shock wave lithotripsy of lower calyx calculi: How much is treatment outcome influenced by the anatomy of the collecting system? Eur Urol 2007; 52: 539-46.