Abstract
OBJECTIVE: To evaluate whether tamsulosin hydrochloride is effective as an adjunctive medical therapy to increase the effectiveness of extracorporeal shock-wave lithotripsy (ESWL) for treating ureteric stones, and minimises the use of analgesic drugs after the procedure. PATIENTS AND METHODS: To treat single ureteric stones of 5-15 mm in diameter, 130 patients were treated with ESWL. After treatment, equal numbers of patients were randomly assigned to receive either the standard medical therapy alone (controls) or combined with 0.4 mg tamsulosin daily for ⩽12 weeks. All patients were followed up for 3 months or until an alternative treatment was offered. RESULTS: At 3 months the treatment was considered to be clinically successful in 55/65 (85%) of those receiving tamsulosin and in 58/65 (89%) of the controls (P = 0.34). When patients were classified according to stone size the success rate was similar in both groups (P = 0.22) for those with a stone of >10 mm. However, ureteric colic was reported in 12% of patients treated with standard therapy but in only 5% of those treated with tamsulosin (P = 0.006). The mean cumulative diclofenac dose was 380 mg/patient in the tamsulosin group and 750 mg/patient in the control group (P = 0.004). CONCLUSIONS: This study showed the effectiveness of tamsulosin as an adjunctive medical therapy after ESWL for ureteric stones, but it did not improve stone clearance when treating ureteric stones. However, it decreased the use of analgesics and reduced the complication rate, especially for steinstrasse.