Neeli Siddalingeshwar
Department of Urology, Jawaharlal Nehru Medical College, Belagavi, India.
Asian J Urol. 2021 Oct;8(4):430-435. doi: 10.1016/j.ajur.2021.03.005. Epub 2021 Mar 26.
To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving clearance of fragments after shock wave lithotripsy (SWL) to treat renal calculi.
Between January 2016 to December 2017, 140 patients with solitary, non-branched, non-lower calyceal renal calculus and measuring less than 20 mm and treated with SWL were randomized to tamsulosin (group A) or tamsulosin plus tadalafil (group B). Therapy was given for a period of 4 weeks. Stone clearance rate, analgesic requirement, occurrence of steinstrasse, need for auxiliary procedures (endoscopic treatment), and adverse effects of drugs were recorded.
The overall clearance rate was 72.5% (50/69) in the group A and 90.1% (64/71) in the group B (=0.007). For stones up to 12 mm, the difference in the clearance rate was significant (=0.039) while it was not so for stones larger than 12 mm (=0.151). There was no statistically significant difference between the two groups with regards to analgesic requirement (=0.94), occurrence of steinstrasse (=0.101), need for auxiliary procedures (=0.76), and adverse effects of the drugs (=0.148).
Our study shows that adjunctive medical expulsive therapy with tamsulosin and tadalafil achieves better clearance rate than tadalafil alone in patients receiving SWL for renal stones.
比较坦索罗辛与坦索罗辛联合他达拉非在冲击波碎石术（SWL）治疗肾结石后实现碎片清除的疗效。
2016年1月至2017年12月期间，140例接受SWL治疗的孤立性、非分支、非下盏肾结石患者，结石直径小于20mm，被随机分为坦索罗辛组（A组）或坦索罗辛联合他达拉非组（B组）。治疗为期4周。记录结石清除率、镇痛需求、石街发生率、辅助程序（内镜治疗）需求及药物不良反应。
A组总体清除率为72.5%（50/69），B组为90.1%（64/71）（P=0.007）。对于直径达12mm的结石，清除率差异有统计学意义（P=0.039），而对于直径大于12mm的结石则无显著差异（P=0.151）。两组在镇痛需求（P=0.94）、石街发生率（P=0.101）、辅助程序需求（P=0.76）及药物不良反应（P=0.148）方面无统计学显著差异。
我们的研究表明，在接受SWL治疗肾结石的患者中，坦索罗辛联合他达拉非的辅助药物排石疗法比单用他达拉非能实现更好的清除率。
