title: Role of tamsulosin in clearance of upper ureteral calculi after extracorporeal shock wave lithotripsy: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the role of tamsulosin in stone clearance in patients with upper ureteral stone after extracorporeal shock wave lithotripsy (SWL).
  
  
  METHODS
  This randomized controlled trial was performed on 117 patients with a single upper ureteral calculus undergoing SWL. The study group received 0.4 mg tamsulosin daily while the control group received hydration and analgesic on demand for a maximum of 3 months. Follow-up visits were performed at 1, 2, and 3 months after SWL. Efficiency of tamsulosin was evaluated in terms of success rate, time for expulsion of fragments, number of SWL sessions, incidence of steinstrasse, and pain intensity.
  
  
  RESULTS
  The clearance rate after 1, 2, and 3 months were higher in tamsulosin group than the control group (85%, 89.8%, and 91.5% versus 70.6%, 79.3%, and 86.2%; P = .01, P = .11, and P = .34, respectively). The mean time for expulsion of the fragments was 26.78 ± 11.96 days and 31.28 ± 18.31 days in tamsulosin and control groups, respectively (P = .138). Steinstrasse developed in 8 patients in tamsulosin group and in 13 patients in control group (P = .167). Visual analogue scale pain score was 24.92 ± 7.57 in tamsulosin group and 41.81 ± 17.24 in control group (P = .000).
  
  
  CONCLUSIONS
  Tamsulosin helps in clearance of upper ureteral stones after 1 month of SWL, particularly stones with size of 11 to 15 mm with less requirement of SWL sessions and analgesics.
authors.affiliation: Department of Urology, Pt. B.D. Sharma University of Health Sciences, Rohtak, India. drsinghsantosh@yahoo.co.in
authors.forename: Santosh Kumar
authors.initials: SK
authors.lastname: Singh
authors.forename: Devendra Singh
authors.initials: DS
authors.lastname: Pawar
authors.forename: Mahavir Singh
authors.initials: MS
authors.lastname: Griwan
authors.forename: Jag Mohan
authors.initials: JM
authors.lastname: Indora
authors.forename: Sachit
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D014514:Ureteral Calculi / Q000628:therapy*; D055815:Young Adult
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin