Ureteric Stone Clinical Trial
Official title:
The Use of Tamsulosin in Treatment of (10-15 mm) Lower Ureteric Stones in Adults With Non-emergent Symptoms: A Prospective Randomized Study
To estimate the efficacy of tamsulosin in:
A - Expulsion of lower ureteric stones from10-15 mm diameters (primary goal).
B - Pain relief and hyronephrosis improvement (secondary goal).
Urolithiasis affects 4-15% of world population and the incidence of this disease is
increasing day by day . Of all the urinary tract stones, 20% are ureteral stones, and 70% of
these ureteral stones are found in the distal part of the ureters . The goal of treatment of
patients suffering from ureteral calculi is to achieve complete stone clearance with minimal
morbidity .
Ureteral calculi of any size may be associated with renal obstruction and care must be taken
to prevent irreversible damage to kidney, whether patient selects expectant or active
treatment . An expectant treatment or watchful waiting approach may be expected to produce
spontaneous stone expulsion up to 50% of cases but some complications such as urinary
infection, hydronephrosis, and repetitive colicky pain may occur . Once a conservative
approach proves to be unsuccessful, interventional treatment becomes necessary. After a
period of conservative treatment, however, intervention is often inefficient or has a higher
risk for complications due to stone impaction and the associated inflammatory reaction of the
ureter . Non-invasive treatment with extracorporeal shockwave lithotripsy and minimal
invasive approach with ureteroscopy allow ureterolithiasis to resolve in almost all cases but
these procedures are not risk free and they require some experience and not cost effective .
The therapeutic potential of α-blockers for ureteral stone disease has been investigated,
prompted by the detection of α-receptors in ureteral smooth muscle cells . We choose to focus
on tamsulosin because it is the most frequently studied α-blocker, recommended in urology
treatment guidelines, and, in our experience, the most common medical expulsive therapy used
by emergency physicians .
The objective of this trial was to evaluate the efficacy of MET with tamsulosin for ureteral
stones from 10-15 mm diameter in a randomised, placebo-controlled setting.
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