Singal Rikki, Bhatia Gaurav, Mittal Amit, Singal Samita, Zaman Muzzafar
Department of Surgery, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India.
Department of Radiodiagnosis and Imaging, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India.
Avicenna J Med. 2017 Jul-Sep;7(3):115-120. doi: 10.4103/ajm.AJM_87_16.
This study aims to evaluate the efficacy of tamsulosin and alfuzosin for the distal ureteral stone. This study assessed the spontaneous passage and expulsion of the stone.
The study was conducted in the Department of Surgery at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, from May 2013 to May 2014. A total number of 136 patients diagnosed as distal ureteric stone (US) of size <10 mm were included in this study. It was divided into two groups (I and II) out of which 36 cases were excluded. Group I received tablet tamsulosin 0.4 mg/day, and Group II received alfuzosin 10 mg/day. The efficacy of tamsulosin and alfuzosin as an adjunctive medical therapy was determined.
Both the drugs can be safely used for the distal USs. The stone expulsion rate was seen in 36 patients (72.0%) in Group I, and in 34 patients (68.0%) in Group II ( = 0.545). The passage of stones noticed by 32 patients in each Groups I and II ( = 1.000). The mean number of pain attacks was 2.91 ± 1.01 for Group I, and 1.8 ± 0.83 for Group II ( < 0.001 and < 0.001). Thus, we propagate the use of alfuzosin significantly lower number of pain attacks. The drug-related side-effects were postural hypertension (four in Group I and one in Group II) and retrograde ejaculation (eight in Group I, and one in Group II). Thus, the difference was statistically significant in terms of retrograde ejaculation but insignificant for postural hypotension.
There is no difference between both medications in term of efficacy (passing stones) for the management of distal ureteral stones. Both medications are safe and effective. In addition, alfuzosin was better tolerated than tamsulosin as it has fewer side effects.
本研究旨在评估坦索罗辛和阿夫唑嗪治疗远端输尿管结石的疗效。本研究评估了结石的自然排出情况。
本研究于2013年5月至2014年5月在阿姆巴拉穆拉纳市玛哈瑞希·马尔康德什瓦尔医学科学与研究学院外科进行。本研究共纳入136例诊断为远端输尿管结石（US）且结石大小<10mm的患者。将其分为两组（I组和II组），其中36例被排除。I组患者服用坦索罗辛片0.4mg/天，II组患者服用阿夫唑嗪10mg/天。确定了坦索罗辛和阿夫唑嗪作为辅助药物治疗的疗效。
两种药物均可安全用于远端输尿管结石。I组36例患者（72.0%）出现结石排出，II组34例患者（68.0%）出现结石排出（P=0.545）。I组和II组各有32例患者结石排出（P=1.000）。I组疼痛发作的平均次数为2.91±1.01次，II组为1.8±0.83次（P<0.001和P<0.001）。因此，我们发现阿夫唑嗪使用后疼痛发作次数显著减少。药物相关副作用包括体位性高血压（I组4例，II组1例）和逆行射精（I组8例，II组1例）。因此，逆行射精方面差异有统计学意义，体位性低血压方面差异无统计学意义。
在治疗远端输尿管结石的疗效（结石排出）方面，两种药物无差异。两种药物均安全有效。此外，阿夫唑嗪耐受性优于坦索罗辛，因为其副作用较少。
