Liu Guanlin, Cheng Yue, Wu Weijie, Jia Xiaolong, Hu Jiasheng, Xie Guohai, Chen Xueqin
1 Department of Urology, The Ningbo No. 1 Hospital, Zhejiang University , Ningbo, P.R. China .
2 Ningbo Key Laboratory of Translational Medicine in Urinary Diseases, The Ningbo No. 1 Hospital, Zhejiang University , Ningbo, P.R. China .
J Endourol. 2018 Feb;32(2):161-167. doi: 10.1089/end.2017.0560. Epub 2018 Jan 3.
The obstruction of the urinary tract by calculi at the narrowest anatomical areas leads to impaired drainage and severe pain. The aim of this study was to evaluate a new technology, extracorporeal physical vibrational lithecbole (EPVL) combined with tamsulosin, as a treatment for distal ureteral calculi (DUC).
Between July 2013 and July 2014, 672 patients diagnosed with DUC were randomly divided into three groups; a group receiving EPVL plus 0.4 mg oral tamsulosin daily (PO qd) (experimental group, n = 236), a group receiving 0.4 mg tamsulosin PO qd (n = 222), and a group receiving EPVL only (n = 214) (control groups).
There were no significant differences in general characteristics between the three groups. Stone diameters ranged from 0.32 to 1 cm. In the EPVL plus tamsulosin group, 60.1% of patients showed detectable fragment expulsion at 48 hours, and 91.1% were stone free at 7 days. Compared with the two control groups, these rates were significantly higher (EPVL group was 0% and 50.5% and medical expulsive therapy group was 0% and 50.0%, p < 0.05). The stone-free rates were similar in the three groups 2 weeks later (94.5%, 93.6%, and 93.5%; p > 0.05). Patients in the EPVL plus tamsulosin group achieved similar stone-free rates compared with the other two groups, but the speed of the stone expulsion was quicker for both sexes and all age groups (about a week; p < 0.05).
This indicates that EPVL plus tamsulosin could be used as an effective, but faster treatment option for patients with DUC, alleviating the symptoms of DUC in a shorter period of time.
尿路结石在最狭窄的解剖区域造成梗阻,导致引流不畅和剧痛。本研究旨在评估一种新技术——体外物理振动排石术(EPVL)联合坦索罗辛治疗远端输尿管结石(DUC)的效果。
2013年7月至2014年7月期间,672例被诊断为DUC的患者被随机分为三组;一组接受EPVL联合每日口服0.4mg坦索罗辛(实验组,n = 236),一组接受每日口服0.4mg坦索罗辛(n = 222),另一组仅接受EPVL治疗(n = 214)(对照组)。
三组患者的一般特征无显著差异。结石直径范围为0.32至1厘米。在EPVL联合坦索罗辛组中,60.1%的患者在48小时时可见结石碎片排出,7天时结石清除率为91.1%。与两个对照组相比,这些比率显著更高(EPVL组分别为0%和50.5%,药物排石治疗组分别为0%和50.0%,p < 0.05)。两周后三组的结石清除率相似(94.5%、93.6%和93.5%;p > 0.05)。EPVL联合坦索罗辛组患者与其他两组的结石清除率相似,但无论男女及各年龄组,结石排出速度更快(约一周;p < 0.05)。
这表明EPVL联合坦索罗辛可作为DUC患者的一种有效但更快的治疗选择,能在更短时间内缓解DUC症状。