Abstract

Introduction Extracorporeal shock wave lithotripsy (ESWL) is an effective treatment for urolithiasis. Tamsulosin is capable of causing dilation and facilitating the migration of stones. The aim of this study is to evaluate the efficacy of adjuvant treatment with tamsulosin for improving the stone-free rate after a single session of ESWL in the treatment of kidney stones. Methods This is a randomized, nonplacebo-controlled study with a sample of 60 adults with a single radiopaque kidney stone of 5–20 mm in diameter. After the ESWL session, the patients were divided into two groups. The control group received standard treatment for analgesia consisting of oral diclofenac (75 mg/12 h) as needed. The tamsulosin group received standard treatment for analgesia plus oral tamsulosin (0.4 mg/day) for eight weeks. In both groups, stone-free status was determined using a CT scan eight weeks after ESWL. The protocol of this study was registered with ClinicalTrials.gov, identifier: NCT04819828. Results Only 57 patients completed the study (28 tamsulosin and 29 control). Overall, the average stone diameter was 11.42 ± 4.52 mm. The stone-free rate was 50.88% (29 of 57) overall, 53.57% (15 of 28) for the tamsulosin group, and 48.27% (14 of 29) for the control group (p = 0.680). The estimated relative risk in favor of the tamsulosin group to achieve a stone-free status was 1.11 (95% CI 0.67–1.9). The estimated number needed to treat to achieve a single patient with renal stone-free status after eight weeks of ESWL adjuvant treatment with tamsulosin was 19. Conclusion Our findings suggest that tamsulosin as adjuvant treatment after a single ESWL session is well tolerated and safe, but it does not increase the stone-free rate in patients with a single radiopaque renal stone of 5–20 mm in diameter. Our results may support the use of tamsulosin with ESWL in the case of patients with a single radiopaque renal stone of 11–20 mm in diameter based on an apparent higher stone-free rate and a low rate of complications.

Highlights

  • Extracorporeal shock wave lithotripsy (ESWL) is an effective treatment for urolithiasis

  • A total of 362 patients with a single radiopaque kidney stone of 5–20 mm in diameter and visible on a computed tomography (CT) scan of the abdomen were recruited during the screening phase

  • During the follow-up period, treatment was suspended for one patient who presented with adverse effects characterized by symptomatic hypotension in the tamsulosin group (1 of 30; 3.33%)

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Summary

Introduction

Extracorporeal shock wave lithotripsy (ESWL) is an effective treatment for urolithiasis. E aim of this study is to evaluate the efficacy of adjuvant treatment with tamsulosin for improving the stone-free rate after a single session of ESWL in the treatment of kidney stones. E tamsulosin group received standard treatment for analgesia plus oral tamsulosin (0.4 mg/day) for eight weeks In both groups, stone-free status was determined using a CT scan eight weeks after ESWL. Because of its efficacy and low morbidity, extracorporeal shock wave lithotripsy (ESWL) is an effective treatment for kidney stones smaller than 20 mm in diameter [4]. E aim of this study was to evaluate the efficacy of adjuvant treatment with tamsulosin for improving the stone-free rate after a single session of ESWL in the treatment of radiopaque kidney stones International Journal of Clinical Practice type of medication for spontaneous calculus expulsion [9, 10], but there is no conclusive evidence of the adjuvant effectiveness of tamsulosin after ESWL for stone clearance and even less among a Mexican population.

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