ESWL联合坦索罗辛治疗输尿管结石的疗效分析

目的：评价α1受体阻滞剂坦索罗辛在ESWL治疗输尿管结石中的辅助排石效果。方法：将符合条件的160例输尿管结石患者彳FESWI。治疗后随机分成两组，一组给予常规治疗作为对照，另一组（观察组）除给予常规治疗外，增加坦索罗辛0．4mg／d。结果：在观察时问内，对照组排石率（53％）明显低于观察组（74％），两组之间的差异有统计学意义（P〈0．05）。结论：坦索罗辛能提高输尿管结石ESWL治疗后的排石率，可作为输尿管结石ESWL治疗后的辅助排石疗法．     

ESWL联合坦索罗辛治疗输尿管下段结石的探讨

目的：探讨ESWL联合坦索罗辛治疗输尿管结石并促进结石排出的有效性与安全性。方法：对80例单发输尿管下段结石患者在应用ESWL治疗后分组进行为期2周的临床观察，40例采用保守治疗（对照组），即每天饮水2L，必要时采用非甾体类抗炎药物缓解症状；40例除采用保守治疗外，加用坦索罗辛0．4mg，每天1次（治疗组）。结果：ESWL后2周，两组均行影像学检查。对照组排石率为47．5％（19／40），治疗组为77．5％（31／40）。2周内，两组发生肾绞痛分别为15％（6／40）和7．5％（3／40）。治疗组有2例发生轻微头晕乏力。结论：坦索罗辛可以显著提高ESWL后的结石排出率，减少发生肾绞痛机率，不良反应轻微，是输尿管下段结石ESWL后辅助排石的治疗方法之一。     

坦索罗辛预防肾结石ESWL术后并发症的临床研究

目的探讨坦索罗辛对肾结石体外冲击波碎石（ESWL）术后排石的疗效及对并发症的预防作用。方法120例单纯肾结石行ESWL术患者，结石直径8—22mm，随机分成2组，坦索罗辛组60例，给予氟罗沙星、排石冲剂及坦索罗辛（哈乐），对照组60例，给予氟罗沙星、排石冲剂，治疗时间4周，比较2组之间结石排净率、石街的形成、疼痛评分（VAS）、膀胱刺激症状。结果坦索罗辛组的结石排净率（88．3％）高于对照组（71．7％）（P=0．022），坦索罗辛组石街形成率（6．7％）低于对照组（16．7％）（P=0．040），坦索罗辛组疼痛VAS评分[2（0-7）分]低于对照组[4（0-8）分（P〈0．01）]，坦索罗辛组膀胱刺激症状发生率（10％）低于对照组（21．7％）（P=0．024）。治疗期间2组未出现药物不良反应。结论ESWL术后坦索罗辛能够促进ESWL术后结石排出，预防石街形成，缓解疼痛及膀胱刺激症状，可以作为肾结石ESWL术后排石的辅助用药。     

坦索罗辛在较大输尿管结石ESWL后辅助排石中的作用

目的：探讨ESWL治疗较大输尿管结石术后应用坦索罗辛以提高结石清除率的有效性与安全性.方法：应用随机对照的临床试验方法,对120例较大输尿管结石（直径〉10 mm）患者进行了为期4周的研究,在接受首次ESWL治疗后,对照组（n=60）接受保守治疗,治疗组（n=60）除保守治疗外,每天口服坦索罗辛0.4mg.结果：首次ESWL后2周随访末,治疗组的结石清除率（71.67%,43/60）显著高于对照组（53.33%,32/60）（P=0.038）,期间绞痛平均次数及平均VAS评分显著低于对照组.第2次ESWL后2周随访末,治疗组的结石清除率（85.00%,51/60）显著高于对照组（68.33%,41/60）（P=0.031）.结论：ESWL后应用坦索罗辛可以提高较大输尿管结石清除率及治疗效率,尤其对于输尿管远段结石效果显著,而且可以减轻术后绞痛,不良反应发生率低.     

坦索罗辛联合体外冲击波碎石治疗输尿管下段结石疗效观察

目的探讨坦索罗辛联合体外冲击波碎石(ESWL)治疗输尿管下段结石的临床疗效。方法选取2008-06—2012-03泌尿外科收治的120例输尿管下段结石患者为研究对象,随机分为对照组和治疗组各60例。对照组ESWL后给予消炎痛和排石颗粒治疗,治疗组在对照组基础上口服坦索罗辛。观察2组的疗效。结果治疗组结石排除率显著高于对照组,且排石时间短于对照组。镇痛剂的使用率及肾绞痛再发率均低于对照组,2组比较差异均有统计学意义(P<0.05)。结论坦索罗辛可提高ESWL术后输尿管下段结石的排石率,减少肾绞痛发作,可作为输尿管下段结石ESWL后辅助排石治疗方法。     

坦索罗辛联合双氯芬酸钠在输尿管下段结石辅助排石中的作用

目的评价坦索罗辛与双氯芬酸钠联合治疗在输尿管下段结石辅助排石中的临床效果。方法91例确诊单纯输尿管下段结石的患者，年龄18～57岁，结石4～10mm，随机分为3组：空白对照组、坦索罗辛（0．2mg，1次／d）对照组、联合治疗组（服用坦索罗辛和双氯芬酸钠）。3组间患者的年龄、性别、结石直径等差异均无统计学意义。随访1周，观察结石排出率、结石排出时间、肾绞痛发生、镇痛剂使用情况和药物不良反应。结果联合治疗组、坦索罗辛组的结石完全排出率分别为90．0％、69．0％，均显著高于对照组的40．0％（P均〈0．05）；结石排出时间、肾绞痛发生率和镇痛剂的使用率分别为（8．20±1．56）d、20．0％、3．3％和（9．21±1．59）d、44．8％、20．7％，也均显著低于对照组的（11．40±1．73）d、64．0％和48．0％（P均〈0．05）。且联合治疗组的结石排出率明显高于坦索罗辛组，结石排出时间、肾绞痛发生率和镇痛药使用率也均低于后者。3组患者均未观察到明显的药物不良反应。结论坦索罗辛联合双氯芬酸钠可明显促进输尿管下段结石排出，缓解肾绞痛发生，可作为一种有效的输尿管下段结石辅助药物疗法。     

坦索罗辛和山莨菪碱对输尿管下段结石体外冲击波碎石（ESWL）术后辅助排石的疗效比较

目的分析比较坦索罗辛和山莨菪碱在输尿管下段结石体外冲击波碎石术后辅助排石的疗效。方法90例输尿管下段结石患者随机分3组，每组30例，结石直径0．4—1．0cm。对照组未给予输尿管平滑肌松弛剂；山莨菪碱组给予山莨菪碱10mg，3次／d；坦索罗辛组给予坦索罗辛0．4mg，1次／d。每例患者治疗观察期不超过2周。结果2周内结石排出者对照组为27例（86．7％），山莨菪碱组为28例（93．3％），坦索罗辛组为28例（93．3％）。各组比较排石率无显著差异（P〉0．05）。各组平均排石时间分别为（5．6±4．0）d、（5．2±2．8）d、（4．6±2．7）d，山莨菪碱组、坦索罗辛组较对照组时间短，差异有统计学意义（P〈0．01），坦索罗辛组较山莨菪碱组短，差异有统计学意义（P〈0．01）。结论在输尿管下段结石体外冲击波碎石术后，坦索罗辛和山莨菪碱在辅助排石方面是安全、有效的，能缩短结石排石时间，坦索罗辛作用优于山莨菪碱。     

体外冲击波碎石治疗输尿管结石影响疗效的相关因素分析

目的探讨体外冲击波碎石（ESWL）治疗输尿管结石影响疗效的相关因素。方法收集2009年1月至2013年1月我院采用ESWL治疗单发输尿管结石的392例患者的临床资料,对11个可能导致排石失败的因素进行单因素和多因素logistic回归分析。结果ESWL治疗输尿管结石成功率80．1％（314／392）。单因素分析显示患者结石位置、结石直径、病程和术后服用坦索罗辛等因素在排石成功和排石失败的两组患者中差异有统计学意义（P〈0．05）。多因素logistic回归分析显示,结石直径≥10mm,结石位于输尿管中、下段和病程≥60d为排石失败的独立危险因素（OR分别为2．625、1．973、1．754、1．483,P均〈0．05）,术后服用坦索罗辛为保护性因素（OR=0．542,P〈O．05）。结论ESWL治疗输尿管结石的疗效与多种因素有关,结石位置、结石直径和病程是ESWL治疗输尿管结石失败的独立危险因素,术后服用坦索罗辛为保护性因素。     

盐酸坦索罗辛在输尿管微小结石排石中的作用

目的：探讨α1肾上腺素能受体阻滞剂，盐酸坦索罗辛在输尿管微小结石排石中的效果。方法：64例输尿管微小结石随机分成两组。组Ⅰ为对照组，应用排石冲剂1包（25g），3次／d；组Ⅱ为试验组，在对照组治疗方案基础上予以口服盐酸坦索罗辛0．4mg，1次／d。每例患者观察时间不超过2周。结果：在观察时间内两组排石率分别为42．3％和79．9％，两组比较差异有系统学意义（P〈0．01）。观察时间内两组再次发生肾绞痛而需要镇痛药物治疗的患者分别为15．4％和7．9％。两组比较差异有统计学意义（P〈0．01）。组Ⅱ除1例发生头晕外，无其他不良反应发生。结论：盐酸坦索罗辛能提高输尿管微小结石的排石率，减少再发生肾绞痛的几率，且安全有效，可作为输尿管微小结石辅助排石的方法。     

赛洛多辛治疗输尿管下段结石的有效性和安全性的Meta分析

目的采用Meta分析的方法,评价赛洛多辛治疗输尿管下段结石的有效性和安全性。方法检索PubMed、Cochrane图书馆、Embase,将赛洛多辛与安慰剂、坦索罗辛治疗输尿管下段结石的随机对照研究(RCT)纳入分析。结果纳入9个RCT,包括1 048例患者,分别比较了赛洛多辛与安慰剂、赛洛多辛与坦索罗辛治疗输尿管下段结石的排石率、排石时间和主要不良反应。结果显示:与安慰剂相比,赛洛多辛对输尿管下段的排石率(OR=2.82,95%CI=1.70~4.67,P0.000 1)显著增加、排石时间(SMD=-4.71,95%CI=-6.60~-2.83,P0.000 01)显著缩短。与坦索罗辛相比,赛洛多辛对输尿管下段的排石率(OR=2.54,95%CI=1.70~3.78,P0.000 01)也明显增加、排石时间(SMD=-2.64,95%CI=-3.64~-1.64,P0.00001)明显缩短、肾绞痛发作频次(P0.000 01)明显下降。但与坦索罗辛相比,赛洛多辛射精异常的发生率显著增加,而在其他并发症方面,两者无明显差异(OR=1.00,95%CI=0.58~1.74,P=1.00)。结论与安慰剂和坦索罗辛相比,赛洛多辛治疗输尿管下段结石、缓解肾绞痛更有效。赛洛多辛除了逆向射精发生率较高外,在安全性方面与坦索罗辛相当。     

α‐Blockers to assist stone clearance after extracorporeal shock wave lithotripsy: a meta‐analysis

Study Type – Therapy (meta‐analysis)
Level of Evidence 1a

OBJECTIVE

To review the evidence for the use of α‐blockers after extracorporeal shock wave lithotripsy (ESWL) in enhancing the effectiveness of renal and ureteric stone clearance.

METHODS

We searched MEDLINE, Embase and the Cochrane Library up to January 2009. All randomized controlled trials in which α‐blockers were evaluated after ESWL were eligible for the analysis. Outcome measures assessed were clearance rate (primary) and expulsion time (secondary). Two authors independently assessed study quality and extracted data. All data were analysed using RevMan 5.

RESULTS

Of the 29 identified papers, seven trials with a total of 484 patients met the predefined criteria. These studies evaluated the effectiveness of the α‐blocker tamsulosin, and studied clearance rate as the primary outcome. There was large heterogeneity between trials, but their methodological quality was adequate. The pooled absolute risk difference of clearance rate was 16% (95% confidence interval 5–27%) in favour of the tamsulosin group, i.e. an average of six patients have to be treated with tamsulosin after ESWL to achieve clearance in one. Subgroup analysis for the six studies that used a dose of 0.4 mg tamsulosin showed a pooled risk difference of 19 (10–29)%. The expulsion time was analysed in three studies and the pooled mean difference was 8 (?3–20) days in favour of the tamsulosin group. Pain and analgesic usage was reported to be lower with tamsulosin. Adverse effects of tamsulosin, mainly dizziness, were reported in eight patients (3%).

CONCLUSIONS

Treatment with tamsulosin after ESWL appears to be effective in assisting stone clearance in patients with renal and ureteric calculi. To make a definite clinical recommendation to use tamsulosin after ESWL for renal and ureteric calculi, a high quality confirmatory trial is warranted.     

Rapid extracorporeal shock wave lithotripsy treatment after a first colic episode correlates with accelerated ureteral stone clearance

OBJECTIVES: To investigate the relationship between delay in extracorporeal shock wave lithotripsy (ESWL) after a first colic and subsequent time to complete stone clearance. METHODS: This prospective, non-randomized study included 94 patients treated with ESWL for unilateral solitary proximal ureteral stones after at least one episode of colic pain. Time between the first onset of colic pain and ESWL and stone clearance was recorded. The pretherapeutic degree of hydronephrosis has been assessed using ultrasound. RESULTS: Mean stone size was 7.9 +/- 2.3 mm and mean time before ESWL after a first colic was 93.4 +/- 143.5 h. At 3 months, 3 patients were lost to follow-up. In 76.9% of patients stones were completely cleared and a further 3.3% harbored residual fragments < or =3 mm. Delay in treatment after a first colic correlated with subsequent time to stone clearance (p < 0.0001). Mean time to stone clearance in patients treated within 24h was 6.4 +/- 6.3 days compared with 16.0 +/- 17.8 days for those treated later (p = 0.008). Maximum stone diameter correlated with time to stone clearance (p = 0.031), but the degree of hydronephrosis did not. CONCLUSIONS: Rapid ESWL after a first onset of colic pain resulted in accelerated stone clearance independent of the degree of hydronephrosis but had no impact on the need for auxiliary procedures.     

Efficacy of expulsive therapy using nifedipine or tamsulosin,both associated with ketoprofene,after shock wave lithotripsy of ureteral stones

Extracorporeal shock wave lithotripsy (ESWL) is currently considered one of the main treatments for ureteral stones. Some studies have reported the effectiveness of pharmacologic therapies (calcium antagonists or alpha-blockers) in facilitating ureteral stone expulsion after ESWL. We prospectively evaluated the efficacy, after ESWL, of nifedipine on upper-middle ureteral stones, and tamsulosin on lower ureteral stones, both associated to ketoprofene as anti-edema agent. From January 2003 to March 2005 we prospectively evaluated 113 patients affected by radiopaque or radiolucent ureteral stones. Average stone size was 10.16 ± 2.00 mm (range 6–14 mm). Thirty-seven stones were located in the upper ureter, 27 in the middle ureter, and 49 in the lower ureter. All patients received a single session of ESWL (mean number of shock waves: 3,500) by means of a Dornier Lithotripter S (mean energy power for each treatment: 84%). Both ultrasound and X-ray were used for stone scanning. After treatment, 63 of 113 patients were submitted to medical therapy to aid stone expulsion: nifedipine 30 mg/day for 14 days administered to 35 patients with upper-middle ureteral stones (group A1) and tamsulosin 0.4 mg/day for 14 days administered to 28 patients with stones located in the distal ureter (group A2). The remaining 50 patients were used as a control group (29 upper–middle ureteral stones—B1—and 21 lower ureteral stones—B2—), receiving only pain-relieving therapy. No significant difference in stone size between the groups defined was observed. Stone clearance was assessed 1 and 2 months after ESWL by means of KUB, ultrasound scan and/or excretory urography. A stone-free condition was defined as complete stone clearance or the presence of residual fragments smaller than 3 mm in diameter. The stone-free rates in the expulsive medical therapy group were 85.7 and 82.1% for the nifedipine (A1) and tamsulosin (A2) groups respectively; stone-free rates in the control groups were 51.7 and 57.1% (B1 and B2, respectively). Five patients (14.3%) in group A1, 5 (17.8%) in group A2, 14 (48.3%) in group B1 and 9 (42.8%) in group B2 were not stone-free after a single ESWL session and required ESWL re-treatment or an endoscopic treatment. Medical therapy following ESWL to facilitate ureteral stone expulsion results in increased 1- and 2-month stone-free rates and in a lower percentage of those needing re-treatment. The efficacy of nifedipine for the upper-mid ureteral tract associated with ketoprofene makes expulsive medical therapy suitable for improving overall outcomes of ESWL treatment for ureteral stones.     

Is there a role for tamsulosin in shock wave lithotripsy for renal and ureteral calculi?

PURPOSE: We evaluated the effect of the alpha-blocker tamsulosin on stone clearance, analgesic requirements and steinstrasse in shock wave lithotripsy for solitary renal and ureteral calculus. MATERIALS AND METHODS: A prospective, double-blind, randomized placebo controlled study was performed during 1 year involving 60 patients with a solitary renal or ureteral calculus undergoing shock wave lithotripsy. The control group (30) received 0.4 mg tamsulosin and the study group (30) received placebo daily until stone clearance or for a maximum of 30 days. An oral preparation of dextropropoxyphene hydrochloride and acetaminophen was the analgesic used on an on-demand basis. The parameters assessed were stone size, position, clearance time, effect on steinstrasse and analgesic requirement. RESULTS: The overall clearance rate was 96.6% (28 of 29) in the study group and 79.3% (23 of 29) in the control group (p = 0.04). With larger stones 11 to 24 mm the difference in the clearance rate was significant (p = 0.03) but not so with the smaller stones 6 to 10 mm (p = 0.35). The average dose of analgesic used was lower with tamsulosin than with controls, without statistical significance. Steinstrasse resolved spontaneously in the tamsulosin group whereas 25% (2 of 8) required intervention in the placebo group. There was no difference between the 2 groups with regard to age, stone size or location. CONCLUSIONS: The alpha-blocker tamsulosin seemed to facilitate stone clearance, particularly with larger stones during shock wave lithotripsy for renal and ureteral calculus. It also appeared to improve the outcome of steinstrasse. Tamsulosin may have a potential role in routine shock wave lithotripsy.     

Efficacy of extracorporeal shock wave lithotripsy for solitary lower calyceal stone: a statistical model

OBJECTIVE: To evaluate the effect of inferior calyceal radiographic anatomy, number of extracorporeal shock wave lithotripsy (ESWL) sessions and stone size on the successful clearance of solitary inferior calyceal calculi after ESWL. PATIENTS AND METHODS: In a prospective study between January 2001 and November 2002, 66 renal units with a solitary inferior calyceal calculus of < or = 2 cm were treated with electrohydraulic ESWL. The infundibulopelvic angle (two definitions), infundibulovertebral angle, inferior calyceal infundibular diameter, infundibular length, cortical thickness over the lower pole, number of minor calyces and stone size were determined from intravenous urography before treatment. The number of ESWL sessions was also included in the analysis. Treatments which produced residual fragments not clearing within 3 months of satisfactory fragmentation were considered as failures. All patients in whom the treatment failed were treated successfully by percutaneous nephrolithotomy. The data were then analysed using two different statistical methods; first by intravariable differences using the test of proportion (Fisher's test) and then all the variables together using logistic regression. RESULTS: At 3 months 78.8% of the renal units were clear of stone. All intravariable differences were statistically significant except stone size (<1 cm, 1-2 cm). In a multivariate analysis of all variables, only stone size was the most important predictor for successful stone clearance (P = 0.03). CONCLUSIONS: ESWL is the initial treatment of choice in selected patients with inferior calyceal stones. The stone size appears to be the most important predictor for stone clearance.     

Effect of tamsulosin on the number and intensity of ureteral colic in patients with lower ureteral calculus

BACKGROUND: We aimed to objectively determine whether tamsulosin as an alpha(1)-blocker was effective in patients who had ureterolithiasis located in the lower part of the ureter. METHODS: Sixty patients with lower ureteral calculi (juxtavesical or intramural portion) were included in the present study. Conservative treatment, such as hydration and tenoxicam as a non-steroidal anti-inflammatory drug, was given to group 1 (30 patients). Group 2 (30 patients) was given tamsulosin (0.4 mg daily) in addition to the conservative treatment. All patients were followed up and questioned about the numbers and intensity of ureteral colic, and the rates of spontaneous passage after the procedure. RESULTS: Spontaneous passage was observed in 22 of the 30 patients in group 1 (73.3%) and 26 of the 30 patients in group 2 (86.6%). The difference within groups 1 and 2 was not significant (P=0.196). The difference between both groups was not statistically significant either, with the stone diameter being 6 mm (P=0.635) or >6 mm (P=0.407). As group 1 patients were passing their stones, they had more ureteral colic episodes than group 2 patients. This difference was statistically significant and correlated well with the administration of tamsulosin (P=0.038). Group 1 patients reported higher scores according to a visual analog scale than group 2 patients. Also, this difference was statistically significant (P=0.000). CONCLUSIONS: We think that the treatment of alpha(1)-blockers decreased the number of ureteral colic episodes and the intensity of pain during spontaneous passage at the lower ureteral calculi. Also, it will be beneficial to patients' quality of life.     

输尿管软镜碎石术前预置双J管必要性的荟萃分析

目的 系统评价输尿管软镜碎石术前预置双J管的必要性。方法 计算机检索Pubmed、CochraneLibrary、Embase、Scopus、万方、中国知网、维普数据库。检索从建库至2018年11月关于术前预置双J管对输尿管软镜碎石术治疗效果影响的临床研究。英文检索词为Flexible ureteroscopic、preoperative、Double J stent、Calculus,中文检索词为输尿管软镜、术前、双J管、结石。纳入标准:①病例对照研究或随机对照试验,包括学位论文及会议摘要;②研究对象术前经泌尿系超声、腹部X线片、尿路造影或腹部CT等检查确诊为泌尿系结石,均行输尿管软镜碎石术;③试验组术前预置双J管,对照组术前不预置双J管;④观察指标包括术后结石清除率、通道鞘置入成功率、球囊扩张使用率、术中及术后并发症发生率、手术时间等。排除标准:①无对照组;②相同的作者、单位的重复报告;③未涉及相关指标或原始数据不完整,无法提取利用的文献。由2名研究者独立进行文献筛选、质量评价、提取资料,并使用RevMan 5.3统计软件进行Meta分析。结果 本研究共纳入46篇文献,其中病例对照试验32篇,随机对照试验14篇。共纳入17 480例患者,其中试验组6 211例,对照组11 269例。Meta分析结果显示,试验组术后结石清除率高于对照组(OR=1.69,95%CI 1.37~2.08,P<0.05)。亚组分析结果显示,肾结石亚组中,试验组结石清除率高于对照组(OR=1.67,95%CI 1.41~1.99,P<0.05);输尿管结石亚组中,两组差异无统计学意义(OR=1.71,95%CI 0.91~3.20,P=0.100)。试验组的软镜通道鞘置入成功率高于对照组(OR=5.77,95%CI 3.32~10.31,P<0.05),球囊扩张器使用率低于对照组(OR=0.23,95%CI 0.15~0.35,P<0.05),术中并发症发生率低于对照组(OR=0.56,95%CI 0.38~0.84,P=0.004),术后并发症发生率低于对照组(OR=0.64,95%CI 0.45~0.90,P=0.010),手术时间短于对照组(MD=-4.95,95%CI -8.90^-1.01,P=0.010)。结论 术前预置双J管可提高输尿管软镜碎石术治疗肾结石的术后结石清除率,提高软镜通道鞘的置入成功率,降低输尿管球囊扩张器的使用率,减少术中、术后并发症的发生率,缩短手术时间。     

Rapid extracorporeal shock wave lithotripsy for proximal ureteral calculi in colic versus noncolic patients

OBJECTIVES: In delayed extracorporeal shock wave lithotripsy (ESWL) treatment, increasing stone impaction is associated with delayed stone clearance. Whether colic patients treated by rapid ESWL have the same time to stone clearance as noncolic patients, which supports the thesis that stones in both groups are nonimpacted, has not been investigated yet, and was the objective of this study. METHODS: A total of 82 patients were prospectively enrolled and treated with piezoelectric ESWL for a solitary proximal ureteral stone. Of these, 56 patients experienced at least one colic episode compared with 26 noncolic patients. Hydronephrosis has been assessed with the use of ultrasound and intravenous urography (IVU). Time to stone clearance after the first ESWL and stone-free rates after a follow-up period of 3 mo were recorded. RESULTS: In colic and noncolic patients, mean stone size was 7.8mm (p=0.7). Ultrasound-detected hydronephrosis was present in 88% versus 39% (p<0.0001), whereas IVU-detected hydronephrosis was present in 60% versus 7.7% (p=0.0001). Mean number of impulses applied was 8000+/-4000 versus 6700+/-3400 (p=0.1). Mean time to stone clearance was 9.5+/-12.1 d versus 4.6+/-3.8 d (p=0.1). Colic and noncolic patients were considered as treatment success in 83% and 81% after 3 mo of follow-up (p=0.9). CONCLUSIONS: Treatment outcome and time to stone clearance after rapid ESWL in colic patients compared with noncolic patients is comparable and independent of concomitant hydronephrosis. This finding suggests an absence of significant impaction in proximal ureteral stones treated within 24h after a first colic episode, enforcing the concept of performing rapid ESWL in patients harbouring proximal ureteral stones.     

Low dose tamsulosin for stone expulsion after extracorporeal shock wave lithotripsy: Efficacy in Japanese male patients with ureteral stone

Objective:   We evaluated the efficacy of low dose tamsulosin after extracorporeal shock wave lithotripsy (ESWL) in Japanese male patients with ureteral stone.
Methods:   One hundred and two Japanese male patients with ureteral stones who underwent ESWL were randomly divided into three groups. Group A (38 patients) was given tamsulosin (0.2 mg/day); group B (30 patients) was given c horeito , a herbal medicine (7.5 g/day); and group C (34 patients) received no medication. Stone clearance was assessed at 1, 7, 14, and 28 days after ESWL using plain abdominal radiography and abdominal ultrasonography. After 28 days, stone delivery was checked every 2 weeks.
Results:   The stone-free rate was 84.21%, 90%, and 88.24% for groups A, B, and C, respectively ( P  = 0.3425). The mean expulsion time was 15.66 ± 6.14 days in group A, 27.74 ± 25.36 days in group B, and 35.47 ± 53.70 days in group C. The expulsion time of group A was significantly shorter than that of groups B ( P  = 0.0116) and C ( P  = 0.0424).
Conclusions:   The addition of tamsulosin to conservative treatment appeared to be effective in shortening the stone expulsion time.