title: Tamsulosin or Silodosin Adjuvant Treatment Is Ineffective in Improving Shockwave Lithotripsy Outcome: A Short-Term Follow-Up Randomized, Placebo-Controlled Study.
abstract: The role of α-blockers after shockwave lithotripsy (SWL) is controversial. The aim of our study was to evaluate the effect of tamsulosin and silodosin after SWL for kidney stones.
  
  
  
  From 2012 onward, a consecutive series of patients undergoing SWL were prospectively enrolled and randomized by closed envelopes in three groups receiving tamsulosin 0.4 mg (A), silodosin 8 mg (B), and placebo (C) daily for 21 days after SWL. Anthropometrics, stone size, and location were recorded before SWL. Visual analogue scale (VAS) score was collected at 6, 12, and 24 hours after treatment to evaluate patients' discomfort. Stone-free rate was assessed 1 and 3 weeks postoperatively. Complications and medical treatment-related adverse events (AEs) were recorded. Differences in VAS score, stone-free rate, and complications were compared among the groups.
  
  
  
  Overall, 60 patients were enrolled. Mean stone sizes were 10.28 ± 2.46 mm, 10.45 ± 1.73 mm, and 9.23 ± 2.04 mm in groups A, B, and C, respectively (p = 0.474). There was no significant difference between the three groups with regard to stone location. Comparable energy was used to treat patients from the three groups. The overall 3-week stone-free rate was 53%: 58% in the tamsulosin group, 47% in the silodosin group, and 55% in the placebo group (p = 0.399). No significant differences were observed in the VAS scores reported by the groups at 6 hours (p = 1.254), 12 hours (p = 0.075), and 24 hours (p = 0.490). Overall, 12 complications were reported: 11 patients (7 in group C and 4 in group B) needed analgesics for colic, and 1 patient (group B) was surgically treated for Steinstrasse. Tamsulosin was superior to placebo (p = 0.008) and silodosin (p = 0.021) in preventing complications; no difference between silodosin and placebo (p = 0.629) was noted.
  
  
  
  Tamsulosin and silodosin are ineffective in increasing stone-free rate as well as early patients' discomfort after extracorporeal lithotripsy.
authors.affiliation: Department of Urology, Sant'Andrea Hospital, "Sapienza", University of Rome , Rome, Italy .
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.affiliation: Department of Urology, Sant'Andrea Hospital, "Sapienza", University of Rome , Rome, Italy .
authors.forename: Aldo
authors.initials: A
authors.lastname: Brassetti
authors.affiliation: Department of Urology, Sant'Andrea Hospital, "Sapienza", University of Rome , Rome, Italy .
authors.forename: Mariangela
authors.initials: M
authors.lastname: Bellangino
authors.affiliation: Department of Urology, Sant'Andrea Hospital, "Sapienza", University of Rome , Rome, Italy .
authors.forename: Alberto
authors.initials: A
authors.lastname: Trucchi
authors.affiliation: Department of Urology, Sant'Andrea Hospital, "Sapienza", University of Rome , Rome, Italy .
authors.forename: Stefano
authors.initials: S
authors.lastname: Petta
authors.affiliation: Department of Urology, Sant'Andrea Hospital, "Sapienza", University of Rome , Rome, Italy .
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Presicce
authors.affiliation: Department of Urology, Sant'Andrea Hospital, "Sapienza", University of Rome , Rome, Italy .
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D056844:Renal Colic / Q000188:drug therapy / Q000209:etiology; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D053039:Ureterolithiasis / Q000209:etiology; D064804:Urological Agents / Q000627:therapeutic use*
chemical_list: D000317:Adrenergic alpha-Antagonists; D000700:Analgesics; D007211:Indoles; D013449:Sulfonamides; D064804:Urological Agents; C095285:silodosin; D000077409:Tamsulosin