Sayed Mohamed Abdel-Basir, Abolyosr Ahmad, Abdalla Medhat Ahmad, El-Azab Ahmad Shehata
Urology Department, Assiut University, Assiut, Egypt.
Scand J Urol Nephrol. 2008;42(1):59-62. doi: 10.1080/00365590701571076. Epub 2007 Aug 24.
To evaluate the potential role of tamsulosin in the medical treatment of distal ureteral stones.
Ninety patients with symptomatic distal ureteral calculi were enrolled. They were randomly divided into two groups: Group A (n=45) received diclofenac 100 mg on demand for 4 weeks plus levofloxacin 250 mg daily for the first week and were well hydrated; and Group B (n=45) received the same therapy plus tamsulosin 0.4 mg/daily for 4 weeks. Abdominal ultrasound scans and KUB X-rays were performed weekly. Stone expulsion rates, time to expulsion, pain episodes and analgesic usage were determined. Intervention by means of shock-wave lithotripsy (SWL) or ureteroscopy was evaluated.
The stone expulsion rate was 51.1% for Group A, compared to 88.9% for Group B (p=0.001). The average time to expulsion was 12.53+/-2.12 days for Group A and 7.32+/-0.78 days for Group B (p=0.04). The number of pain episodes was significantly lower in Group B and mean use of analgesics was lower for Group B (0.14+/-0.5 vials) than Group A (2.78+/-2.7 vials). Twenty-two patients in Group A failed to pass their stones after 4 weeks but only five in Group B. Of the patients who were not stone-free, 19 were treated with SWL and eight underwent ureteroscopy.
Our study reveals the efficacy of tamsulosin for the treatment of distal ureteral stones. Tamsulosin should be added to the standard medical approach for treating these stones.
评估坦索罗辛在远端输尿管结石药物治疗中的潜在作用。
纳入90例有症状的远端输尿管结石患者。他们被随机分为两组：A组（n = 45）按需服用双氯芬酸100 mg，持续4周，加用左氧氟沙星250 mg，每日1次，共1周，并充分水化；B组（n = 45）接受相同治疗，加用坦索罗辛0.4 mg/每日，持续4周。每周进行腹部超声扫描和KUB X线检查。测定结石排出率、排出时间、疼痛发作次数和镇痛药物使用情况。评估冲击波碎石术（SWL）或输尿管镜检查的干预情况。
A组结石排出率为51.1%，B组为88.9%（p = 0.001）。A组平均排出时间为12.53±2.12天，B组为7.32±0.78天（p = 0.04）。B组疼痛发作次数明显较少，B组平均镇痛药物使用量（0.14±0.5瓶）低于A组（2.78±2.7瓶）。A组22例患者在4周后结石未排出，但B组仅5例。在结石未排出的患者中，19例接受了SWL治疗，8例接受了输尿管镜检查。
我们的研究揭示了坦索罗辛治疗远端输尿管结石的疗效。坦索罗辛应添加到治疗这些结石的标准药物治疗方案中。
