Moursy Essam, Gamal Wael M, Abuzeid Abdelmenem
Urology Department, Sohag University Hospital, Sohag, Egypt.
Scand J Urol Nephrol. 2010 Nov;44(5):315-9. doi: 10.3109/00365599.2010.494616. Epub 2010 Jun 21.
Steinstrasse is a well-known complication following extracorporeal shockwave lithotripsy (ESWL). The objective of this study was to evaluate the efficacy of tamsulosin as a management of steinstrasse.
88 patients with unilateral steinstrasse were treated between January 2005 and December 2008. The patients were randomly allocated into two equal groups. There were no significant differences between groups for age, gender, stone location, stone length or stone fragment size (p > 0.05). Patients in group 1 (study group) received a single daily morning dose of tamsulosin (0.4 mg) for a maximum of 4 weeks, in addition to pain-relieving therapy. Patients in group 2 (control group) received only the pain-relieving therapy. All patients were checked weekly with a plain X-ray of the urinary tract, urinary ultrasonography, urine analysis and serum creatinine. Pain episodes, day of spontaneous stone expulsion, total analgesic dosage and drug side-effects were recorded.
Stone expulsion occurred in 32 of the 44 patients (72.7%) receiving tamsulosin and in 25 of the 44 patients (56.8%) in the control group. Patients receiving tamsulosin had a significantly higher stone expulsion rate (p = 0.017). There were no significant differences between groups for mean stone expulsion time or number of analgesics used. Twelve patients (27.3%) in the group receiving tamsulosin and 19 patients (43.3%) in the control group needed hospitalization; the group difference was statistically significant (p = 0.017).
When compared with no treatment, tamsulosin can significantly facilitate expulsion of retained ureteral stone fragments following ESWL.
“石街”是体外冲击波碎石术（ESWL）后一种众所周知的并发症。本研究的目的是评估坦索罗辛对“石街”的治疗效果。
2005年1月至2008年12月期间，对88例单侧“石街”患者进行了治疗。患者被随机分为两组，每组人数相等。两组在年龄、性别、结石位置、结石长度或结石碎片大小方面无显著差异（p>0.05）。第1组（研究组）患者除接受止痛治疗外，每天早晨服用一次坦索罗辛（0.4毫克），最长服用4周。第2组（对照组）患者仅接受止痛治疗。所有患者每周进行一次泌尿系统平片、超声检查、尿液分析和血清肌酐检查。记录疼痛发作情况、结石自然排出日期、总止痛剂量和药物副作用。
接受坦索罗辛治疗的44例患者中有32例（72.7%）结石排出，对照组44例患者中有25例（56.8%）结石排出。接受坦索罗辛治疗的患者结石排出率显著更高（p = 0.017）。两组在平均结石排出时间或使用的止痛药物数量方面无显著差异。接受坦索罗辛治疗组的12例患者（27.3%）和对照组的19例患者（43.3%）需要住院治疗；组间差异具有统计学意义（p = 0.017）。
与未治疗相比，坦索罗辛可显著促进ESWL后输尿管内残留结石碎片的排出。
