PROSPECTIVE STUDY OF TAMSULOSIN IN THE MANAGEMENT OF CALCULI IN LOWER THIRD OF URETER

• Published in: Journal of evolution of medical and dental sciences Vol. 4; no. 34; pp. 5805 - 5816
• Main Authors: Sinha, Arunabha, Joshi, Shirin, Shivkumar, K.S, Singh, R.N, Ray, Nisith
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 27.04.2015
• Subjects: Calculi, Urinary; Drug therapy; Patient outcomes; Tamsulosin hydrochloride
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2015/851

INTRODUCTION: Urinary calculus disease is one of the 3 most common urological diseases. It affects about 12% of the world population and has become a worldwide health problem. Of all the urinary tract stones 20% are ureteral stones, of which 70% are found in the lower third of ureter. Patients with ureteric calculi have wide range of complications which includes acute pain necessitating hospitalization, urinary tract infection, anuria, acute renal failure, chronic renal failure, hydronephrosis, pyonephrosis, pyelonephritis. The objective of the study is, to study the effect of Tamsulosin in the passage of calculi in the lower one third of the ureter compared to NSAIDs and oral and IV fluids. MATERIAL AND METHOD: This study included a total of 82 patients between the study period from Nov 2010 to May 2013. 42 patients were chosen randomly and advised to take plenty of oral fluids and treated with NSAIDs (Diclofenac sodium) and the other 40 patients were treated with Tamsulosin (alpha blocker) 0.4mg HS for one month along with oral fluids and NSAIDs (Diclofenac sodium). RESULTS: Majority of the patients were in the age group of 20-40 yrs. The mean size of the calculus was 6.62 cms on the right side and 6.07 cms on the left side. Out of the 40 patients who were on alpha 1 blocker (Tamsulosin) 31 patients had passed the calculi and 9 patients had no results with a success rate of 77.5%. In the 42 patients who were not on Tamsulosin, 8 patients passed the calculi and 34 patients did not pass the calculi. 9 patients among the 42 underwent ureterorenoscopy (URS). CONCLUSION: Tamsulosin is an effective and safe drug in the management of calculi in the lower 1/3rd of the ureter. Most patients with ureteric calculi were rendered stone free with endourological procedures if conservative treatment failed. KEYWORDS: Ureteric stones, Alpha 1 blocker, Tamsulosin, Ureteroscopy.