Hussein Mohamed M
Urology Department, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt.
Scand J Urol Nephrol. 2010 Feb;44(1):27-31. doi: 10.3109/00365590903359916.
To evaluate the efficacy of the selective alpha-blocker tamsulosin on stone clearance after shockwave lithotripsy (SWL) of renal stones.
A prospective, randomized, controlled study was carried out in 166 patients who underwent SWL for renal stones between January and December 2007. Group 1 (n = 83) took tamsulosin 0.4 mg once daily and diclofenac sodium injection (75 mg) on demand. Group 2 (n = 83) took only diclofenac sodium as needed. Patients were on this regimen for 4 weeks or until stone clearance and were followed up for a maximum of 3 months. They were evaluated for stone clearance, time to stone clearance, colic attacks, need for analgesics and any side-effects at 2 weeks, and 1, 2 and 3 months.
In total, 136 patients (67 in group 1 and 69 in group 2) were available for evaluation. The demographic profile was comparable in both groups. Group 1 had a clearance rate of 73% (49/67) versus 55% (38/69) in group 2 (p = 0.008). Time to stone clearance was significantly different at 1, 2 and 3 months (p = 0.02, 0.01 and 0.008, respectively), but not significant at 2 weeks (p = 0.52). In group 2, higher number of patients had more frequent attacks of colic and used more analgesics than in group 1 (p = 003, 0.001 and 0.002, respectively). Nine patients (13.4%) in group 1 had ejaculatory dysfunction.
Tamsulosin significantly increases stone clearance after SWL of renal stones. It decreases the pain and amount of analgesics needed, with a low rate of side-effects.
评估选择性α受体阻滞剂坦索罗辛对肾结石冲击波碎石术（SWL）后结石清除率的疗效。
对2007年1月至12月间接受肾结石SWL治疗的166例患者进行了一项前瞻性、随机对照研究。第1组（n = 83）患者每日服用一次0.4 mg坦索罗辛，并按需使用双氯芬酸钠注射液（75 mg）。第2组（n = 83）仅按需使用双氯芬酸钠。患者采用该方案治疗4周或直至结石清除，最长随访3个月。在2周、1个月、2个月和3个月时评估患者的结石清除情况、结石清除时间、绞痛发作情况、镇痛需求及任何副作用。
共有136例患者（第1组67例，第2组69例）可供评估。两组的人口统计学特征具有可比性。第1组的结石清除率为73%（49/67），而第2组为55%（38/69）（p = 0.008）。在1个月、2个月和3个月时，结石清除时间有显著差异（分别为p = 0.02、0.01和0.008），但在2周时无显著差异（p = 0.52）。与第1组相比，第2组有更多患者绞痛发作更频繁且使用了更多镇痛药（分别为p = 0.03、0.001和0.002）。第1组有9例患者（13.4%）出现射精功能障碍。
坦索罗辛可显著提高肾结石SWL后的结石清除率。它可减轻疼痛及所需镇痛药的用量，且副作用发生率低。
