اثر داروي تامسولوسين در تسهيل عبور سنگ هاي ژوگستاوزيكال

The effect of Tamsulosin in facilitating of juxtavesical stones passage

Introduction: We evaluated the effectiveness of tamsulosin and nifedipine during watchful waiting in patients with juxtavesical ureteral stone . Materials and Methods : Between Oct 2003 and Feb 2004 , 382 patients with renal colic referred to our center which 64 patients suffered from juxtavesical stone less than 1 cm where enrolled in the study and were randomly divided into 3 groups. The average sizes of the stones were 6.7 mm, 6.4 mm, 6.8 mm in Groups 1, 2, 3. Group 1 (20 Patients) received Nifidipine daily oral treatment of 0.4 mg tamsulosin and group 2 (20 Patients) received 20 mg nifedipine daily oral therapy, group 3 (24 Patients) were used as controls. The patients were treated about 4 weeks and the patients were every 1 week and sonography was done for 4 weeks and whenever the stone was expulsed, we discounted the drug. Information about stones passage and time and complication was noted. Statistical analyses were performed with using the K2 test. Results: We had 35 males and 29 females patients with mean age of 38 years, According to patients age, sex and stone size there was no significant difference between 3 groups. The stone passage rate was 90% (8 Patients), 75% (14 Patients) and 45% (11 Patients) in groups 1, 2, 3 respectively. The difference in group 1 and 2 with respect to group 3 was significant. Average expulsion time was 16 days, 20 days and 18 days in 3 groups respectively. A statistically significant difference was noted between group 1 and 3. Two patients from group 1, five patients from group 2 and thirteen patients from group 3 underwent transureteral lithotripsy. Conclusions: Tamsulosin and nifedipine administration in renal colic due to juxtavesical calsuli increased the stone expulsion rate, reduced expulsion time and decreased need for hospitalization and endoscopic procedures.