الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
Summary
amsulosin as an adjuvant treatment after SWL for patients
with renal and upper ureteric stones
A prospective randomized study
Objective:
To assess tamsulosin as an adjuvant treatment for
patients with renal and upper ureteric stones after shock
wave lithotripsy (SWL), regarding stone expulsion rate and
analgesic dose.
Patients and methods:
This is a prospective randomized study carried out on 96
male patients with upper urinary tract stones who were
divided randomly into 2 groups. Group I (47 patients):
received Tamsulosin 0.4mg once daily plus diclofenac
(50/75mg) oral or parenteral as needed for pain relief. Group II
(49 patients): received only diclofenac (50/75mg) oral or
parenteral for pain relief.
All patients were investigated two weeks after the
SWL session by
T
Summary
117
(K.U.B), and (U/S) to assess disintegration of stones
or clearance and the need for further sessions with a
maximum of 3 sessions per patient and follow up duration of
2 weeks after 3rd session. All patients with fragments
5mm or greater were considered as candidates for
another SWL session. Patients with residual less than 5mm
were considered as clinical insignificant fragment (CIF).
Cases with no evidence of clearance or (CIF) after 2 weeks
follow up of 3rd SWL session were considered failure.
Reassessment and another treatment modality were chosen for the
patient. Documentation of clearance rate, time and analgesics
dose was noted for each patient in both groups.
Results:
The mean age for group I was 28.6 years and for group II
was 29.5 years. The p-value was 0.980 and therefore, no
significant difference in the age group was present. The mean
stone size for group I was 13mm and for group II was 12.3.The
p-value was 0.1071with no significant difference.
In our study, total patients in group I had an expulsion rate
of 80.9%. In contrast, group II had an expulsion rate of 57.1%.
The p-value of this parameter was 0.022 which was found
statistically significant.
Summary
118
Considering the expulsion in patients with kidney stones,
group I had expulsion rate of 80%. In contrast, group II had
expulsion rate of 48.5%. The p-value of this parameter was 0.013
which was significant.
Regarding patients with ureteric stones, the expulsion rate
was 83.3% in group I and 75% in group II, having p-value
of 0.947 which was not significant.
The mean analgesic dose was 565 mg in group I and
1512 mg in group II. The p-value of this parameter was
<0.001 which was significant.
Conclusion:
The use of tamsulosin as a medical expulsive therapy
appears to augment the outcome of SWL by improving the
overall stone clearance rate and time. Also it seems to lower the
post SWL analgesic dose required