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ORIGINAL ARTICLE
Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 202-205

The Efficacy of Tamsulosin as Medical Expulsion Therapy in Ureteric Calculus of <8 mm Size


1 Aditya Birla Hospital, Pune, Maharashtra, India
2 Department of Urology, Institute of Kidney Diseases and Research Centre, Ahmedabad, Gujarat, India
3 Shri Sathya Sai Institute of Higher Medical Sciences, Prashanthigram, Puttaparthy, Andhra Pradesh, India

Correspondence Address:
Dr. Prateek Jugalkishore Laddha
6833/3, Mohar Singh Nagar, St No 8, Hargobind Marg, Ludhiana - 141 008, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_45_17

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Introduction: Many conservative medical therapies have been researched and studied for ureteric stones. Alpha 1- Adrenergic blocker Tamsulosin reduces muscle spasm in the ureteric wall, decreases peristalsis below and raises pressure above the stone thus facilitating stone passage. Material and Methods: Patients diagnosed with ureteric stones from OPD, Casualty/Emergency Room and wards were included in the study. The patients were randomized into the study and the control arms. This was a prospective, randomized, controlled, open label clinical trial conducted on patients presenting to tertiary care center in north India with ureteric colic. Study group received Tamsulosin along with the analgesics, whereas the control group received only symptomatic treatment and hydration. Results: There were 29 (52.7%) subjects in the study group and 25 (45.4%) subjects in the control group had a subjective score of over 9 on arrival. The minimum pain score at presentation was 4 in the study group whereas it was 5 in the control group. Majority of the patients received Inj. Morphine after the initial Inj. Diclofenac sodium, 33 (60%) in the study group and 36 (65.45%) from the control group. There were 12 and 11 in the study and the control group who received an additional morphine infusion pump for pain control. The mean number of colic episodes during treatment was 1.75 (SD=1.534) in study group which was marginally less when compared to that of the control group 1.93 (SD=1.138) (P=0.288).In the study group 41 patients had expelled the stone whereas in the control group 30 of them had expelled at the end of study period, the difference was statistically significant (P=0.03). Conclusion: There was decreased pain score, number of colic episodes on treatment and duration of expulsion in the study group as compared to the control group (P >0.05). The difference in the number of patients who expelled the calculus among both the groups was statistically significant (P=0.03) noted in this study.


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