title: A second cycle of tamsulosin in patients with distal ureteric stones: a prospective randomized trial.
abstract: OBJECTIVE
  To evaluate, in a prospective randomized pilot study, the effectiveness and safety of tamsulosin, administered in patients with distal ureteric stones and who have already undergone an unsuccessful first cycle of medical expulsive therapy (MET).
  
  
  METHODS
  We evaluated the effectiveness and safety of tamsulosin, administered as a further therapy, in patients previously unsuccessfully treated with combined expulsive 10-day therapy (tamsulosin + deflazacort) for distal ureteric stones. Ninety-one patients were enrolled and randomized into two groups, each receiving a different therapy for 10 days. Group A (46 patients) received a further cycle of tamsulosin (0.4 mg daily), and group B (45) did not. Age, gender, stone size, time to expulsion, number of acute episodes of colic during treatment and analgesic consumption were recorded. Patients who were not stone-free after the study period had ureteroscopy. The results were compared statistically using Student's t-, chi-square test and Fisher's exact test.
  
  
  RESULTS
  The groups were comparable in age, gender and stone size (5.93 mm for group A and 6.03 mm for group B). The expulsion rate was significantly higher in group A (80%) than in group B (49%) (P < 0.01), whilst there were no differences between the groups in the number of colic episodes and analgesic use. There were no reported side-effects of medical therapy.
  
  
  CONCLUSIONS
  A second cycle of 10 days of MET with tamsulosin in nonresponders to a 10-day first cycle of MET with tamsulosin and deflazacort is safe and effective, and therefore should be considered as an option in the management of uncomplicated distal ureteric stones.
authors.affiliation: Department of Urology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy. porpiglia@libero.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Porpiglia
authors.forename: Cristian
authors.initials: C
authors.lastname: Fiori
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Ghignone
authors.forename: Davide
authors.initials: D
authors.lastname: Vaccino
authors.forename: Michele
authors.initials: M
authors.lastname: Billia
authors.forename: Ivano
authors.initials: I
authors.lastname: Morra
authors.forename: Francesca
authors.initials: F
authors.lastname: Ragni
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Scarpa
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011282:Pregnenediones / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D019233:Retreatment; D013449:Sulfonamides / Q000008:administration & dosage* / Q000009:adverse effects; D000077409:Tamsulosin; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000188:drug therapy*
chemical_list: D000317:Adrenergic alpha-Antagonists; D011282:Pregnenediones; D013449:Sulfonamides; D000077409:Tamsulosin; C021988:deflazacort