Effect of α1-Adrenergic Antagonists on Lower Ureteral Stones With Extracorporeal Shock Wave Lithotripsy

OBJECTIVE: To evaluate the efficiency of alpha 1-adrenergic antagonists on stone clearance after extracorporeal shock wave lithotripsy (ESWL) in patients with lower ureteral stones. METHODS: A total of 107 patients with solitary lower ureteral stones and who underwent single ESWL sessions were divided into two groups. Group 1 received our standard medical therapy, and group 2 was treated with 0.4 mg/day tamsulosin for a maximum of 2 weeks. All patients were re-evaluated with plain Film radiography and ultrasound each week during treatment. RESULTS: Twenty-four of the 52 patients in group 1(46.2%) and 41 of 55 patients in group 2 (74.5%) (p=0.002) were found to be stone-free. Among patients with stones 10-15 mm in diameter, the stone-free rate was 36.4% in group 1 and 73.0% in group 2 (p=0.003). Average stone expulsion time was 11.6 days and 8.1 days in groups land 2, respectively (p=0.000). Ureteral colic occurred in 10 patients (19.2%) in group 1 but only 3 patients (5.5%) in group 2 (p=0.043). The only side effect of tamsulosin was slight dizziness in 2 of the SS (3.6%) patients in group 2. CONCLUSION: Adjunctive therapy with alpha 1-adrenergic antagonists after ESWL is more effective than, and equally as safe as lithotripsy alone in the treatment of patients with lower ureteral stones. The use of alpha 1-adrenergic antagonists is more useful for stones with a large dimension, and can also reduce stone expulsion time and episodes of ureteral colic. [Asian J Surg 2010;33(1):37-41]