EFFICACY OF TAMSULOSIN IN MEDICAL TREATMENT OF LOWER URETERAL STONES.

Impacted distal ureteral stone have always been controversial on the choice of treatment. This study aims to evaluate the effect of tamsulosin (non selective alpha 1-blocker) in medical expulsion therapy of distal ureteral stones.

Materials &Methods : 96 patients with UVJ or distal ureteral stones (size between 3-6 mm) were randomly divided into two groups. Group 1 (46 patients – the control group) received only indomethacin (100 mg /PRN). Group 2 (50 patients) received indomethacin and tamsulosin (0.4 mg daily). All patients were questioned about the episodes of ureteral colic, dose of Indomethacin, rate and time of spontaneous passage of stones. Patients were followed for 28 days.

Results: 30 of 46 patients (62.5%) in the control group and 41of 50 patients (82%) in tamsulosin group had spontaneous stone passage during 28 days. The expulsion rate were not significantly different between 2 groups (P>0.05). Stone expulsion time was 8.03±4.7 days in control group and 5.07±3.7days in tamsulosin group. This difference was statistically significant (P<0.05). The control group had more ureteral colic episodes and more indomethacin use rather than tamsulosin group. This difference was statistically significant (P=0.05).

Conclusion: Tamsulosin decreases the duration of stones passage, severity of pain and use of analgesics in conservative management of distal ureteral stones , but doesn’t increase the frequency of spontaneous passage of the distal ureteral calculi significantly.