Please wait a minute...
Search Asian J Urol Advanced Search
Share 
Asian Journal of Urology, 2021, 8(4): 430-435    doi: 10.1016/j.ajur.2021.03.005
  本期目录 | 过刊浏览 | 高级检索 |
Effect of tamsulosin versus tamsulosin plus tadalafil on renal calculus clearance after shock wave lithotripsy: An open-labelled, randomised, prospective study
Siddalingeshwar Neeli()
Department of Urology, Jawaharlal Nehru Medical College, Belagavi, India
下载:  HTML  PDF (485KB) 
输出:  BibTeX | EndNote (RIS)      
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
Abstract: 

Objectives: To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving clearance of fragments after shock wave lithotripsy (SWL) to treat renal calculi.
Methods: Between January 2016 to December 2017, 140 patients with solitary, non-branched, non-lower calyceal renal calculus and measuring less than 20 mm and treated with SWL were randomized to tamsulosin (group A) or tamsulosin plus tadalafil (group B). Therapy was given for a period of 4 weeks. Stone clearance rate, analgesic requirement, occurrence of steinstrasse, need for auxiliary procedures (endoscopic treatment), and adverse effects of drugs were recorded.
Results: The overall clearance rate was 72.5% (50/69) in the group A and 90.1% (64/71) in the group B (p=0.007). For stones up to 12 mm, the difference in the clearance rate was significant (p=0.039) while it was not so for stones larger than 12 mm (p=0.151). There was no statistically significant difference between the two groups with regards to analgesic requirement (p=0.94), occurrence of steinstrasse (p=0.101), need for auxiliary procedures (p=0.76), and adverse effects of the drugs (p=0.148).
Conclusion: Our study shows that adjunctive medical expulsive therapy with tamsulosin and tadalafil achieves better clearance rate than tadalafil alone in patients receiving SWL for renal stones.

Key words:  Renal calculus    Shock wave lithotripsy    Tamsulosin    Tadalafil
收稿日期:  2020-04-29      修回日期:  2020-06-02      接受日期:  2020-07-21      出版日期:  2021-10-20      发布日期:  2021-11-08      整期出版日期:  2021-10-20
引用本文:    
. [J]. Asian Journal of Urology, 2021, 8(4): 430-435.
Siddalingeshwar Neeli. Effect of tamsulosin versus tamsulosin plus tadalafil on renal calculus clearance after shock wave lithotripsy: An open-labelled, randomised, prospective study. Asian Journal of Urology, 2021, 8(4): 430-435.
链接本文:  
http://www.ajurology.com/CN/10.1016/j.ajur.2021.03.005  或          http://www.ajurology.com/CN/Y2021/V8/I4/430
  
Characteristic Group A (n=69) Group B (n=71) p-Value
Age, mean±SD, year 40.00±10.08 41.32±10.22 0.442
Gender, n
Male 48 49 0.629
Female 21 22
BMI, mean±SD, kg/m2
Male 22.40±3.03 22.57±3.49 0.781
Female 23.21±2.62 22.34±2.69
Side, n
Right 34 37 0.843
Left 35 34
Stone location, n
Upper calyx 12 14 0.923
Mid calyx 25 26
Renal pelvis 32 31
Stone size, mean±SD, mm 11.75±2.17 11.97±2.13 0.550
Stone size, n (%)
6-12 mm 46 (66.7%) 46 (64.7%) 0.550
13-18 mm 23 (33.3%) 25 (35.3%)
Stone density, mean±SD, HU 854±69 861±71 0.64
Pain score, mean±SD 5.70±1.27 5.72±1.21 0.914
  
Stone size Stone clearance Treatment group, n Total, n p-Value
Group A (tamsulosin) Group B (tamsulosin+tadalafil)
Up to 12 mm Complete 37 45 82 0.007
Partial 9 1 10
Subtotal 46 46 92
>12 mm Complete 13 19 32 0.153
Partial 10 6 16
Subtotal 23 25 48
Overall Complete 50 64 114 0.007
Partial 19 7 26
Total 69 71 140
  
Drug side effect Treatment group, n p-Value
Group A (tamsulosin) Group B (tamsulosin+tadalafil)
None 48 58 0.094
Headache 6 8 0.612
Dizziness 11 3 0.021
Vomiting 1 1 1.000
Nausea 3 1 0.397
Total 69 71 NA
  
Stone size Treatment group, n Total, n p-Value
Group A (tamsulosin) Group B (tamsulosin
+tadalafil)
Up to 12 mm
Steinstrasse 2 2 4 0.692
No steinstrasse 44 44 88
Subtotal 46 46 92
>12 mm
Steinstrasse 11 5 16 0.041
No steinstrasse 12 20 32
Subtotal 23 25 48
Overall
Steinstrasse 13 7 20 0.101
No steinstrasse 56 84 120
Subtotal 69 71 140
  
[1] Roudakova K, Monga M. The evolving epidemiology of stone disease. Indian J Urol 2014; 30:44e8.
[2] Epidemiology HG. And medical management of stone disease. BJU Int 2003; 91:758e67.
[3] Joseph KC, Parek BB, Joshi MJ. Inhibition of growth of urinary type calcium hydrogen phosphate dihydrate crystals by tar-taric acid and tamarind. Curr Sci 2005; 88:1232e8.
[4] Zhu Y, Duijvesz D, Rovers MM, Lock TM. a-Blockers to assist stone clearance after extracorporeal shock wave lithotripsy: A meta-analysis. BJU Int 2010; 106:256e61.
[5] Türk C, Neisius A, Petrik A, Seitz C, Skolarikos A, Thomas K, et al. European Association of Urology guidelines on urolith-iasis. https://uroweb.org/guideline/urolithiasis/ [accessed on 02 March 2020].
[6] Poulakis V, Dahm P, Witzsch U, de Vries R, Remplik J, Becht E. Prediction of lower pole stone clearance after shock wave lithotripsy using an artificial neural network. J Urol 2003; 169:1250e6.
[7] Yang TX, Liao BH, Chen YT, Li H, He Q, Liu QY, et al. A network meta-analysis on the beneficial effect of medical expulsive therapy after extracorporeal shock wave lithotripsy. Sci Rep 2017;7:14429 https://doi.org/10.1038/s41598-017-14862-3.
[8] Gandhi HR, Agrawal C. The efficacy of tamsulosin vs. nifedipine for the medical expulsive therapy of distal ureteric stones: A randomised clinical trial. Arab J Urol 2013; 11:405e10.
[9] Gravina GL, Costa AM, Ronchi P, Galatioto GP, Angelucci A, Castellani D, et al. Tamsulosin treatment increases clinical success rate of single extracorporeal shock wave lithotripsy of renal stones. Urology 2005; 66:24e8.
[10] Gratzke C, Uckert S, Reich O, Schlenker B, Tilki D, Seitz M, et al. PDE5 inhibitors. A new option in the treatment of ure-teral colic? Urologe 2007; 46:1219e23.
[11] Kumar S, Jayant K, Agrawal S, Singh SK. Comparative efficacy of tamsulosin versus tamsulosin with tadalafil in combination with prednisolone for the medical expulsive therapy of lower ureteric stones: A randomized trial. Korean J Urol 2014; 55:196e200.
[12] Hussein MM. Does tamsulosin increase stone clearance after shockwave lithotripsy of renal stones? A prospective, random-ized controlled study. Scand J Urol Nephrol 2010; 44:27e31.
[13] Bhagat S, Chako N, Kerke N, Gopalakrishnan G, Antonisamy B, Devasia A. Is there a role for tamsulosin in shock wave lithotripsy for renal and ureteral calculi? J Urol 2007; 177:2185e8.
[14] Sigala S, Dellabella M, Milanese G, Fornari S, Faccoli S, Palazzolo F, et al. Evidence for the presence of a1 adreno-ceptor subtypes in the human ureter. Neurourol Urodyn 2005; 24:142e8.
[15] Itoh Y, Kojima Y, Yasui T, Tozawa K, Sasaki S, Kohri K. Exam-ination of alpha 1 adrenoceptor subtypes in the human ureter. Int J Urol 2007; 14:749e53.
[16] Losek RL, Mauro LS. Efficacy of tamsulosin with extracorporeal shock wave lithotripsy for passage of renal and ureteral calculi. Ann Pharmacother 2008; 42:692e7.
[17] Taher A, Schulz-Knappe P, Meyer M, Truss M, Forssmann WG, Stief CG, et al. Characterization of cyclic nucleotide phos-phodiesterase isoenzymes in the human ureter and their functional role in vitro. World J Urol 1994; 12:286e91.
[18] Truss MC, Uckert S, Stief CG, Forssmann WG, Jonas U. Cyclic nucleotide phosphodiesterase (PDE) isoenzymes in the human detrusor smooth muscle. II. Effect of various PDE inhibitors on smooth muscle tone and cyclic nucleotide levels in vitro. Urol Res 1996; 24:129e34.
[19] Cardona CEM, García-Perdomo HA. Efficacy of phosphodies-terase type 5 inhibitors for the treatment of distal ureteral calculi: A systematic review and meta-analysis. Investig Clin Urol 2017; 58:82e9.
[20] Griwan MS, Singh SK, Paul H, Pawar DS, Verma M. The effi-cacy of tamsulosin in lower ureteral calculi. Urol Ann 2010; 2:63e6.
[21] Dell’Atti L. Silodosin versus tamsulosin as medical expulsive therapy for distal ureteral stones: A prospective randomized study. Urologia 2015; 82:54e7.
[22] Mehrabi S, Manzouri L, Kohzadi A, Mehrabi F. Efficacy of tamsulosin versus tamsulosin plus lithorex-B as medical expulsive therapy following extracorporeal shock-wave litho-tripsy of renal and upper ureteric stones; a randomized clin-ical trial. J Nephropharmacol 2017; 6:79e84.
No related articles found!
No Suggested Reading articles found!
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed