Mg Of Tamsulosin Research Articles

Semirigid ureteroscopy and tamsulosin therapy as dilatation methods before flexible ureteroscopy: evaluation and benefits

ObjectiveTo evaluate the effect of semirigid ureteroscopy and tamsulosin therapy as dilatation methods before flexible ureteroscopy advancement to the renal collecting system.Patients and methodsThis prospective study included patients with renal stones less than 2 cm who underwent retrograde flexible ureteroscopy and laser lithotripsy. The patients were randomized into two groups: group A patients were given a placebo for 1 week before flexible ureteroscopy, and group B patients were administered 0.4 mg of tamsulosin once daily for 1 week before surgery and underwent active dilatation using semirigid ureteroscopy before flexible ureteroscopy. The ability of the flexible ureteroscope to reach the collecting system in both groups during the same operative session was assessed. Operative outcomes and complications were collected and analyzed in both groups.ResultsA total of 170 patients were included in our study, with each group comprising 85 patients. In group B, the flexible ureteroscope successfully accessed the kidney in 61 patients, while in group A, the flexible ureteroscope was successful only in 28 cases (71.4% versus 32.9%). In group A, 33 (38.8%) patients had lower urinary tract symptoms compared to 17 (20.2%) patients in group B (P = 0.013).ConclusionUsing tamsulosin therapy and semirigid ureteroscopy as dilatation methods before flexible ureteroscopy increased the success of primary flexible ureteroscopy advancement to renal collecting system.

Effectiveness of tadalafil and tamsulosin combination in benign prostatic hyperplasia: A prospective cohort study at a tertiary care center

Background: Benign prostatic hyperplasia (BPH) is one of the major causes of lower urinary tract symptoms (LUTS) in men. The uroselective tamsulosin helps in rapid reduction of prostate symptoms and its combination with Tadalafil, a phosphodiesterase inhibitor leads to synergistic benefit improving the LUTS of BPH. Aims and Objectives: This study was conducted with the aim to assess the effectiveness of synergistic effect of Tadalafil and Tamsulosin in improving the symptoms of BPH patients. Materials and Methods: A prospective cohort study was conducted among the patients admitted with LUTS due to BPH in the surgery ward of Annapoorna Medical College. A total of 100 patients were included in the study. The control group was administered 0.4 mg of tamsulosin and the study group was administered with combination of tadalafil 5 mg and tamsulosin 0.4 mg for 3 weeks and followed up at an interval of 3 weeks, 1 month, and 6 months. Paired t-test was used to compare the international prostate symptom score (IPSS) mean scores. Results: A total of 100 patients were included in the study. There was significant improvement in the post-voided volume of the study group in comparison to the control. The IPPS score of the study group at the baseline was 16.39±4.89 which was decreased to a score of 11.42±3.39 after the combination drug therapy with P<0.001 which was statistically significant. Conclusion: The combination therapy of tamsulosin and tadalafil marked an improvement in the symptoms of BPH which can be noted with fall down of IPSS score after the therapy.

The Role of the Tamsulosin in the Medical Expulsion Therapy for Distal Ureteral Stones

Background: This study aims to assess Tamsulosin's contribution to spontaneous medical expulsion for distal ureteral stones.
 Methodology: The research included 113 patients diagnosed with the distal ureteral stone of 4-10 mm. These patients were introduced to 0.4 mg of Tamsulosin. The technique of KUB ultrasonography was adopted as the means of assessment of stone status following the period of Tamsulosin introduction.
 Results: There was a high frequency of Spontaneous expulsion among the enrolled patients (86.73%). Furthermore, there was a significant effect of age on the frequency of spontaneous expulsion (p=0.008). While gender, disease duration, stone size, and side had no significant effect on the frequency of spontaneous expulsion after Tamsulosin administration for distal ureteral stones.
 Conclusion: It is concluded that Tamsulosin has an efficient impact on triggering spontaneous expulsion among patients with distal ureteral stones.

Comparative study of tamsulosin versus tadalafil in benign prostatic hyperplasia patients with lower urinary tract symptoms. A prospective randomized study.

Introduction:Benign prostatic hyperplasia (BPH) is one of the common causes of lower urinary tract symptoms (LUTS) in aging men. Men with LUTS have a higher incidence of erectile dysfunction (ED), and LUTS themselves represent an independent risk factor for ED, triggering a significant negative impact on quality of life.Materials and Methods:A total of 92 patients were randomly assigned to two groups. Groups I and II had 45 and 47 patients, two patients from Group I and three patients from Group II did not follow and were excluded from the study. Patients in Group I received 0.4 mg of tamsulosin and Group II patients received 5 mg tadalafil. Patients were assessed at baseline, 3 months, and at 6 months after receiving treatment. Treatment efficacy was measured by a change in Qmax, post void residual urine (PVR), International Prostate Symptom Score (IPSS), and Sexual Health Inventory for Men (SHIM) score at 3 months and 6 months.Results:Baseline parameters between the two groups were similar. Mean Qmax improved by 7 ml/s at 3 months to 9.44 ml/s at 6 months in Group I versus 4.73 ml/s at 3 months to 6.46 ml/s at 6 months in Group II (P = 0.739). Mean PVRU decreased by 35.53 ml at 3 months to 47.23 ml at 6 months in Group I versus 44.98 at 3 months to 58.28 ml at 6 months in Group II (P = 0.102). IPSS score improved by 4.24 points at 3 months to 7.22 points at 6 months in Group I versus 4 points at 3 months to 5.02 points at 6 months in Group II (P = 0.336). SHIM score improved by 0.7 points 16.2 at 3 months to 0.8 points at 6 months in Group I versus 6.12 points at 3 months to 6.3 points at 6 months (P < 0.001).Conclusion:When both groups were compared, tadalafil showed statistically similar improvements in Qmax, PVRU, and IPSS score, but statistically significant improvement was observed with tadalafil in SHIM score compared with tamsulosin in treating LUTS secondary to BPH. Our study provides evidence that once daily tadalafil 5 mg is well tolerated and can be considered for the treatment of LUTS secondary to BPH especially in patient with ED.

The effect of preoperative tamsulosin on ureteroscopic access in school-aged children

Flexible ureteroscopes are not tailored for pediatric ureteral size and may not pass at first attempt into the pediatric ureter. Administration of tamsulosin preoperatively in adults has been shown to facilitate ureteral access sheath placement. Several studies have shown tamsulosin to be safe and effective when utilized for medical expulsive therapy in pediatric patients, but its utility for preoperative ureteral dilation has not been studied to date. We hypothesized that preoperative tamsulosin reduces failed ureteroscopic access in children. We conducted a retrospective review of patients aged 0-18 years undergoing flexible ureteroscopy (URS) from 2014 to 2019at a single institution. Patients were divided into those taking 0.4mg of tamsulosin daily for at least 1 week prior to surgery and those not taking tamsulosin. The primary outcome was failure to pass a 7.95 Fr flexible ureteroscope on initial attempt, requiring stent placement and staged management. Patients undergoing URS or stent placement within the prior year, requiring semi-rigid URS, or with genitourinary anomalies were excluded. A total of 49 patients met inclusion criteria. The tamsulosin group (n=13) and non-tamsulosin group (n=36) were similar with respect to demographic data. The percentage of prepubertal patients was 53% vs 33% (p=0.19). The tamsulosin group had lower failed URS (38% vs 61%, p=0.20). When stratified by age, both prepubertal and postpubertal patients in the tamsulosin group had lower failed URS (43% vs 67%, p=0.67 and 33% vs 58%, p=0.38). These clinically significant results suggest initial passage of a flexible ureteroscope is more successful in pediatric patients on preoperative tamsulosin. This study was largely limited by its low power and flaws inherent to its retrospective design. Our results have implications for prescribing tamsulosin preoperatively to reduce multiple procedures and anesthetics in children. Adequately powered prospective trials are warranted to confirm preoperative tamsulosin reduces failed first-attempt flexible URS in children.

Efficacy of Tamsulosin and Alfuzosin in Management of Distal Ureteral Stones

Introduction: Urinary tract calculi are the most frequent condition in urology clinics worldwide. The overall prevalence is about 5 % and lower urinary tract stones account for 70% among them. Medical expulsive therapy has been used to treat distal ureteric stone as it reduces symptoms and facilitates stone expulsion. The aim of this study is to evaluate and compare the efficacy of tamsulosin and alfuzosin as medical therapy in ureteric stones.&#x0D; Materials and Methods: A total of 87 patients with distal ureteral stones of size ≤10 mm were randomly divided into 3 groups. Group A patients (n-30) received 0.4 mg of tamsulosin daily, group B patients (n-29) received 10 mg of alfuzosin daily and group C patients (n-28) received 75 mg of diclofenac sodium. Patients in all groups received diclofenac sodium for one week and then as required. Follow-up was done on a weekly basis for 4 weeks. The stone expulsion rate, time for stone expulsion, and side-effects were recorded in each group.&#x0D; Results: The mean stone size (5.66, 5.79, 5.67) mm and age (29.1, 30.31, 29.4) were comparable in each group. The stone expulsion rate was 83.3%, 79.3%, and 50% in groups A, B, and C respectively. It showed that both the study groups (Group A and Group B) were effective than the control group (p-value 0.006 and 0.02 respectively) but there was no difference between tamsulosin and alfuzosin (p-value 0.69). The duration of stone expulsion was 11.5 days, 11.8 days, and 17.3 days for Group A, B, and C respectively. The drugs related side effects reported by patients were mild and transient.&#x0D; Conclusion: The use of tamsulosin and alfuzosin for the medical treatment of ureteric stones proved to be safe and effective and neither did have any significant benefits over the other.

Preventive effects of tamsulosin for postoperative urinary retention after lower limb arthroplasty: A randomized controlled study.

PurposeThis prospective, randomized, controlled study investigated the use of tamsulosin, a selective alpha-blocker, as a prophylactic medication to prevent postoperative urinary retention (POUR) following lower limb arthroplasty.Materials and MethodsThe criterion for diagnosing POUR was used a postoperative bladder volume over 400 mL with incomplete emptying. Patients who underwent primary total hip or knee arthroplasty were randomly assigned at a 1:1 ratio to tamsulosin treatment and non-treatment groups at a single center from September 2018 to November 2018. The treatment group received 0.2 mg of tamsulosin orally once at night for 3 days starting on postoperative day 1. During this 3-day period, an indwelling Foley catheter was maintained. The incidence of POUR according to tamsulosin treatment following lower limb arthroplasty was the primary outcome.ResultsIn total, 100 patients were enrolled, of whom 5 discontinued participation. POUR was diagnosed in 20 of the remaining 95 patients (21.1%). The treatment group contained 48 patients, of whom 6 (12.5%) developed POUR, whereas POUR occurred in the 14 of the 47 patients (29.8%) in the non-treatment group. Tamsulosin treatment reduced the risk of POUR by two-thirds (odds ratio [OR], 0.337; 95% confidence interval [CI], 0.117–0.971; p=0.044). The risk reduction associated with tamsulosin treatment remained robust post-adjustment for potential covariates (OR, 0.250; 95% CI, 0.069–0.905; p=0.038).ConclusionsTamsulosin administration immediately after lower limb arthroplasty reduced the incidence of urinary retention and diminished the need for long-term catheterization.

A Prospective, Multicenter, Open-Label Study of Dose Escalation Therapy in Male Patients With Nocturia Refractory to 0.2-mg Tamsulosin Monotherapy.

PurposeTo investigate the efficacy and safety of 0.4 mg of tamsulosin in patients with nocturia not responding to 0.2 mg.MethodsPatients with intractable nocturia after treatment with 0.2 mg of tamsulosin for>1 month were included in a multicenter, prospective, observational, single-arm study. Patients were prescribed 0.4 mg of tamsulosin and followed up for 2 months to assess nocturnal voiding and nocturia-related bother. Changes in the mean number of nocturnal voids, the proportion of 50% responders, 3-day frequency-volume chart parameters, and questionnaire scores were assessed.ResultsSixty-two patients were prescribed 0.2 mg of tamsulosin, of whom 56 were prescribed 0.4 mg of tamsulosin. Ten patients dropped out. A single case of orthostatic hypotension was reported. The mean age was 68 years. After 1 and 2 months of taking 0.4 mg of tamsulosin, 23.9% and 22.7% of patients demonstrated a>50% reduction of nocturia, and 16.1% and 19.4% of patients rated the treatment as “very effective,” respectively. Dose escalation to 0.4 mg of tamsulosin, compared to 0.2 mg, did not show an additional effect on reducing nocturnal urine volume. Multivariate logistic regression analysis showed that lower serum sodium levels (odds ratio [OR], 0.41, P=0.037) and the presence of urge incontinence (OR, 7.08, P=0.036) were predictors of a significant improvement of nocturia in response to 0.4 mg of tamsulosin.ConclusionsDose escalation may yield a significant improvement of nocturia in>20% of patients, and may be especially helpful in patients with lower sodium levels and urge incontinence.

Effect of tamsulosin on lower urinary tract symptoms related to double-J ureteral stent: a randomised, double-blinded, placebo controlled trial

Objective: To evaluate the effect of tamsulosin on stent-related symptoms in patients undergoing double-J ureteral stenting. Methods: and materials Seventy patients (47 men and 23 women; mean age 42.5 years) who underwent double-J stent placement in adjunct to urological surgery were prospectively randomised into two groups. Group 1 included 35 patients who received 0.4 mg of tamsulosin once daily for 4 weeks; group 2 included 35 patients who received a placebo for the same protocol. All patients were interviewed by the same physician about the frequency of stent-related symptoms at 4 weeks after stent insertion. Results: Patients in group 1 showed a lower score for suprapubic pain during the filling phase and lower pain during sexual activity than group 2, although the overall pain score was not significantly different between two groups. The mean urinary urgency score was less in group 1 in comparison to the placebo group (p=0.030). No statistically significant differences were found between two groups concerning haematuria, urinary incontinence, frequency nor dysuria. Conclusion: Tamsulosin improves symptoms associated with double-J ureteral stents, especially body pain during sexual activity.

The Effect of Adenorm on the Frequency of Expulsion of Proximal Ureter Calculi: an Open Randomized Controlled Study

Conservative expulsive therapy with the use of alpha-blockers is effective for stones of the lower third of the ureter. Our study was conducted to assess the effectiveness of tamsulosin as part of the drug Adenorm for removing stones from the proximal ureter.Materials and methods. An open, randomized controlled trial was conducted with 108 patients who agreed to the conservative treatment of a single radiopaque calculus of the upper third of the ureter with dimensions ≤6 mm. They were randomly assigned to group A (n=54, only general expulsive therapy) and group B (n=54, which received 0.4 mg of tamsulosin once a day). The primary measure of effectiveness was the frequency of the discharge of calculus (PSC) in the «population of patients with the intention to be treated» after 4 weeks of treatment. Secondary efficacy indicators were evaluated in the «population by protocol» and represented the time of the calculus, the indicator of the Euro-Quality-of-Life scale (EuroQOL – Euro Quality of Life) after the study, the need to take painkillers and the willingness to undergo conservative treatment again.Results. The two groups were well balanced according to the initial characteristics of the patients and the calculus. Seventy-nine patients (73.1%; 35 from group A and 44 from group B) completed the study protocol. The total CHOK was 60.2% (65/108). Group B had a higher FER (74.1%; 40/54) than Group A (46.3%; 25/54; p=0.003) and a significantly shorter stone transit time (average days, A: 19, 6 vs. B: 14.3; p=0.005). The groups did not differ on the EuroQOL scale and on the need for anesthesia, while 74.3% (26/35) of Group A and 90.9% (40/44) of Group B were ready to undergo conservative treatment (p=0.048). Univariate logistic regression analysis showed that stone size (OR=1.474; p=0.045) and treatment with tamsulosin (OR=3.314; p=0.004) significantly influenced the stone’s discharge. In multivariate analysis, only tamsulosin was statistically significant (OR=3.198; p=0.021).Findings. The use of tamsulosin as part of Adenorm was associated with a significantly better frequency of expulsion of stones and a shorter time of their passage, with primary single calculi of the upper third in sizes ≤ 6 mm compared with only conventional expulsive therapy. Our results show that, like patients with stones in the lower third of the ureter, conservative expulsive therapy using tamsulosin is a reasonable treatment option for patients and with calculi of the proximal third of the ureter.

Clinical effects of solifenacin succinate combined with other drugs in treating overactive bladder after transurethral resection of the prostate

Purpose: This research was aimed to explore the clinical situations of solifenacin succinate combined with tamsulosin in treating OAB after TURP. Methods: During experiment, the diagnosed subjects were randomly included into the treatment group and control group, the treatment lasted 7~10 d, 5 mg of solifenacin succinate and 0.2 mg of tamsulosin were given by oral administration once every one day. Scores were assessed as per relevant reference standards (OABSS, IPSS and QOP) before and after treatment. Results: In treatment group, compared with before treatment group, OABSS, IPSS and QOP after treatment decreased significantly after treatment (p<0.05). In control group, compared with before control group, OABSS, IPSS and QOP after treatment decreased significantly after treatment (p<0.05). Conclusion: It can be seen that the solifenacin succinate combined with other drugs has obvious curative effects and less side effects, which can benefit patients in the quality of life and disease treatment.

Medical Expulsive Therapy for Distal Ureteral Stones: Tamsulosin Versus Silodosin in the Turkish Population.

IntroductionOur aim was to contribute a study that includes a higher patient population to the limited number of studies comparing tamsulosin and silodosin in the treatment of distal ureteral stones.Material and methodsPatients who presented with renal colic to the urology emergency clinic and were diagnosed with ureteral stones and followed-up with conservative treatment between January 2010 and January 2016 were retrospectively screened. According to the inclusion-exclusion criteria, the patients were divided into three groups. Group 1: 150 patients followed with watchful waiting (WW), Group 2: 156 patients who received 0.4 mg of tamsulosin daily, and Group 3: 159 patients who received 8 mg of silodosin daily. The side effects of the used drugs, duration of stone reduction, and expulsion rates were evaluated and compared separately.ResultsA total of 465 patients were included in the study. No statistically significant difference was found in terms of age, gender, and stone size among the groups. The patient characteristics and results are shown in Table 1. The differences in stone expulsion rate between the groups in the first week were calculated using the Chi-square test and found to be non-significant (p = 0.155); whereas, the stone expulsion rates between Group 1 versus Group 2 and Group 1 versus Group 3 were found to be significantly different after the second and third week.ConclusionAccording to our results, no statistically significant superiority between tamsulosin and silodosin was shown in the treatment of distal ureteral stones in the Turkish population.

Tamsulosin versus Alfuzosin as medical therapy for ureteric stones

Objectives: To evaluate and compare the efficacy of tamsulosin and alfuzosin as medical therapy in ureteric stones.Patients and Methods: A total of 87 patients with ureteral stones of size ≤10 mm were randomly divided into 3 groups. Group I patients (n-30) received 0.4 mg of tamsulosin daily, group II patients (n-29) received 10 mg of alfuzosin daily and group III patients (n-28) received no alpha blockers. All patients were given analgesia when needed. Follow up was done in weekly basis for 4 weeks.Results: The mean stone size (5.33±1.58, 5.79±1.84, 5.67±1.64) and age (29.1±6.3, 30.31±7.22, 29.4±7.63) were comparable in each groups. The stone expulsion rate was 83.3%, 79.3% and 50% in group I, II and III respectively. The drugs related side effects reported by patients were mild and transient.Conclusion: The use of tamsulosin and alfuzosin for the medical treatment of ureteric stones proved to be safe and effective and neither did have any significant benefits over the other

Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia.

ABSTRACTPurpose Postoperative urinary retention (POUR) is one of the most common complications after surgical procedures under spinal anaesthesia. Recent studies have shown the beneficial effects of alpha-adrenergic blockers in preventing POUR. The aim of this prospective study was to investigate and compare the prophylactic effects of tamsulosin and alfuzosin on POUR after urologic surgical procedures under spinal anaesthesia.Materials and Methods A total of 180 males who underwent elective urologic surgery were included in this study. The patients were randomly allocated into three Groups. The Group I received placebo. Patients in Group II were given 0.4mg of tamsulosin orally 14 and 2 hours before surgery. Patients in Group III were given 10mg of alfuzosin ER orally 10 and 2 hours before surgery. All patients were closely followed for 24 hours postoperatively and their episodes of urinary retentions were recorded.Results There were 60 patients in each Group. Their mean age was 35.95±15.16 years. Fifteen patients in Group I (25%), 3 patients in Group II (5%) and 4 patients in Group III (6.7%) required catheterization because of urinary retention. In tamsulosin group and alfuzosin group, there were a significantly lower proportion of patients with POUR compared with the placebo Group (p=0.002 and p=0.006). The beneficial effects of tamsulosin and alfuzosin on POUR were similar between both Groups (p=0.697).Conclusion This study suggests that the use of prophylactic tamsulosin or alfuzosin can reduce the incidence of urinary retention and the need for catheterization after urologic surgical procedures under spinal anaesthesia.

Tamsulosin does not increase 1-week passage rate of ureteral stones in ED patients

ObjectiveThe objective of the study is to determine if tamsulosin initiated in the emergency department (ED) decreases the time to ureteral stone passage at 1 week or time to pain resolution, compared to placebo. MethodsWe performed a prospective, randomized, double-blinded, placebo-controlled trial of tamsulosin vs placebo in ED patients with ureterolithiasis on computed tomography. Patients were identified and enrolled between April 2007 and February 2009 and were randomized to either 0.4 mg of tamsulosin or placebo for 1 week. We contacted participants using a telephone survey on post-ED visit days 1, 2, 3, and 7. The primary outcome was time to stone passage, with secondary outcomes being maximum pain score and amount of pain medication required. ResultsOf the 127 patients enrolled during this study, 15 were lost to follow-up, and 12 required surgical interventions before the 7-day mark, leaving 100 patients for analysis. Of the 100 patients, 53 received tamsulosin and 47 received placebo. There was no difference between groups in percentage of male, mean age, initial serum creatinine, average stone size, stone location, and history of prior stone. The probability that the patient did not pass a stone at 7 days was not different between tamsulosin and placebo, 62.1% (95% confidence interval, 49.1%-75.1%) vs 54.4% (95% confidence interval, 40.3%-68.6%; P = .58). There was no significant difference in the high pain score (P = .12) or hydrocodone/acetaminophen intake (P = .76) between treatment groups at any of the time points. ConclusionThis study reveals no difference in the proportion of stone passage or high pain score and pain medication utilization at 7 days between tamsulosin and placebo.

Distal Ureteric Stones and Tamsulosin: A Double-Blind, Placebo-Controlled, Randomized, Multicenter Trial

We assess the efficacy and safety of tamsulosin compared with placebo as medical expulsive therapy in patients with distal ureteric stones less than or equal to 10 mm in diameter. This was a randomized, double-blind, placebo-controlled, multicenter trial of adult participants with calculus on computed tomography (CT). Patients were allocated to 0.4 mg of tamsulosin or placebo daily for 28 days. The primary outcomes were stone expulsion on CT at 28 days and time to stone expulsion. There were 403 patients randomized, 81.4% were men, and the median age was 46 years. The median stone size was 4.0 mm in the tamsulosin group and 3.7 mm in the placebo group. Of 316 patients who received CT at 28 days, stone passage occurred in 140 of 161 (87.0%) in the tamsulosin group and 127 of 155 (81.9%) with placebo, a difference of 5.0% (95% confidence interval -3.0% to 13.0%). In a prespecified subgroup analysis of large stones (5 to 10 mm), 30 of 36 (83.3%) tamsulosin participants had stone passage compared with 25 of 41 (61.0%) with placebo, a difference of 22.4% (95% confidence interval 3.1% to 41.6%) and number needed to treat of 4.5. There was no difference in urologic interventions, time to self-reported stone passage, pain, or analgesia requirements. Adverse events were generally mild and did not differ between groups. We found no benefit overall of 0.4 mg of tamsulosin daily for patients with distal ureteric calculi less than or equal to 10 mm in terms of spontaneous passage, time to stone passage, pain, or analgesia requirements. In the subgroup with large stones (5 to 10 mm), tamsulosin did increase passage and should be considered.

Perioperative use of tamsulosin significantly decreases rates of urinary retention in men undergoing pelvic surgery.

Urinary retention is a common complication of pelvic surgery, leading to urinary tract infection and prolonged hospital stays. Tamsulosin is an alpha blocker that works by relaxing bladder neck muscles. It is used to treat benign prostatic hypertrophy and retention. We aim to investigate the potential benefits of preemptive tamsulosin use on rates of urinary retention in men undergoing pelvic surgery. This is a retrospective review of an institutional colorectal database. All men undergoing pelvic surgery between 2004 and 2013 were included. Patients given 0.4 mg of tamsulosin 3 days prior and after surgery at discretion of surgeon starting in 2007 were compared with patients receiving expectant postoperative management. One hundred eighty-five patients were included in the study (study group: N = 30; control group: N = 155). Study group patients were older (56.8 vs. 50.1 years). Overall urinary retention rate was 22% with significantly lower rates in the study group compared with control (6.7 vs. 25%; p = 0.029). Study group had higher rates of minimally invasive surgery (61 vs. 29.7%); however, this did not impact urinary retention rate (20.6 vs. 22.7% for minimally invasive surgery vs. open surgery; p = 0.85). Independent predictors of urinary retention included lack of preemptive tamsulosin (odds ratio (OR), 7.67; 95% confidence interval (CI), 1.4-41.7) and cancer location in the distal third of the rectum (OR, 18.8; 95% CI, 2.1-172.8). Preemptive perioperative use of tamsulosin may significantly decrease the incidence of urinary retention in men undergoing pelvic surgery. This may play a role in avoidance of urinary retention, particularly in patients with distal rectal cancer.

English

BACKGROUND: Medical expulsive therapy has been proven to enhance stone expulsion rate, decrease stone expulsion time and decrease the use of analgesics in lower ureteric calculus. But adequate data is not available on the efficacy of medical expulsive therapy for mid ureteric calculus. Tamsulosin is the most common agent used in medical expulsive therapy along with analgesics. Hence we have studied the efficacy of medical expulsive therapy in this study. PURPOSE: To determine the efficacy of medical expulsive therapy in mid ureteric calculi of up to 10 mm in size- Comparing the results with Placebo and lower ureteric calculi. MATERIAL AND METHODS: It was a prospective randomized study conducted between September 2011 to march 2013. 60 patients with mid ureteric calculi of ≤10 mm and 60 patients with lower ureteric calculi of ≤10 mm were randomly selected for the study. Patients in the study group received 0.4 mg of Tamsulosin and Aceclofenac 100 mg SOS, whereas the control group received only analgesics. Statistical methods used: All the data was collected and analyzed using SPSS 16.0 (2007) software. RESULTS: The stone expulsion rate was higher for patients with mid ureteric calculi who received medical expulsive therapy compared to controls (56.6% Vs. 20%). The stone expulsion rate was higher for patients with lower ureteric calculi compared to patients with mid ureteric calculi (93.3% Vs. 56.6%). CONCLUSION: Medical expulsive therapy can be used with success in patients with mid ureteric calculi up to 10 mm in size. Medical expulsive therapy is more beneficial in patients with lower ureteric calculi as compared to patients with mid ureteric calculi.

Effects of tamsulosin on premature ejaculation in men with benign prostatic hyperplasia.

PurposePrevious studies have revealed that tamsulosin is effective in improving lower urinary tract symptoms (LUTS) and erectile functioning but has some inhibitory effects on ejaculation, including decreased ejaculatory volume. However, these inhibitory effects on ejaculation can be beneficial to patients with premature ejaculation (PE). Therefore, this study was conducted to understand the effect of tamsulosin on PE in men with benign prostatic hyperplasia.Materials and MethodsTwenty-nine patients who visited with LUTS were categorized into 2 groups of LUTS-only patients (n=12) and LUTS combined with PE (LUTS+PE) patients (n=17), and 0.4 mg of tamsulosin was administered to the patients of both groups for 12 weeks. Comparative analyses of before and after the treatment were conducted for calculating the International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), intravaginal ejaculatory latency time (IELT), premature ejaculation diagnostic tool (PEDT), and premature ejaculation profile (PEP). The patients with an IPSS score of 8 or higher were determined as LUTS patients, and the patients with IELT of less than 2 minutess and a PEDT score of 9 or higher were determined as PE patients.ResultsAfter treatment, the IPSS score significantly decreased in both groups. There was no statistically significant change in the PEDT for the LUTS group, but there was a significant decrease in PEDT (p=0.012; from 12.1±3.31 to 8.4±4.49) in the LUTS+PE group.ConclusionsTamsulosin not only has a treatment effect for LUTS but also improves the PE of LUTS+PE patients. Therefore, further studies are needed to confirm the effects of tamsulosin on PE.

Adjuvant alpha adrenergic blockers: Are they equally efficient for renal and upper ureteral calculi disintegrated by shock wave lithotripsy?

Abstract Objectives To evaluate the effects of tamsulosin on stone clearance and analgesic requirements after shock wave lithotripsy (SWL) for solitary renal and upper ureteral calculi. Patients and methods A prospective randomized placebo controlled study was carried out on 126 patients who underwent SWL for solitary radio-opaque renal or upper ureteral calculi ≤20 mm. Patients were randomized into two groups receiving either 0.4 mg of tamsulosin (GT) or placebo (GP). SWL was performed 3-weekly until patients became stone-free or for a maximum of 3 months. Analgesics were used on demand and pain was evaluated by a visual pain scale. Results Renal stones represented 55.6% and 66.7% for GT and GP, respectively ( p = 0.27). Mean renal and ureteral stone size were (12.3 ± 1.8 mm vs. 11.5 ± 2.3 mm, p = 0.14) and (9.7 ± 2.6 mm vs. 8.6 ± 1.7 mm, p = 0.1) for the GT and GP, respectively. GT required fewer SWL sessions for ureteral (1.2 vs. 1.6, p = 0.02) and renal stones (1.8 vs. 2.3, p = 0.08). Stone-free rate (SFR) was higher in GT for upper ureteral stones (96.4% vs. 66.7%, p = 0.01) and renal pelvis stones at a cutoff size >10 mm ( p = 0.01). The mean time of stone clearance was significantly lower in GT (4.2 ± 1.9 weeks vs. 7.5 ± 2.3 weeks, p = 0.001) for ureteral stones. Attacks of renal colic were more frequent in GP (82.5% vs. 44.4%, p = 0.04) with increased demand for analgesia ( p = 0.04). Steinstrasse was recorded in 3 and 7 patients of the GT and GP, respectively ( p = 0.32). Conclusion Tamsulosin facilitates clearance of upper ureteral stone fragments after SWL and decreases the analgesic requirements. These effects were not similarly evident for renal stones.