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Abstract

BACKGROUND: The efficacy of tamsulosin as an adjunctive treatment after extracorporeal shock wave lithotripsy (ESWL) for urolithiasis has increasingly become the subject of interest in the field of Urology. Although tamsulosin is thought to enhance stone passage by relaxing the smooth muscle of the urinary tract, previous studies have generated conflicting evidence regarding its effectiveness in enhancing stone-free rates after ESWL. This inconsistency necessitates further investigation to clarify the role of tamsulosin in optimizing clinical outcomes following ESWL.
OBJECTIVE: To determine the efficacy of tamsulosin as a medical adjunctive after extracorporeal shock wave lithotripsy in proximal ureteric stones.
METHODOLOGY: This descriptive study was carried out on patients presenting to the Department of Urology, Institute of Kidney Diseases, Peshawar, with proximal ureteric stones from April 1, 2024, to October 31, 2024. A total of 195 patients were selected based on inclusion criteria by consecutive non-probability sampling. Data on demographics, stone characteristics, Stone clearance, and stone expulsion time are recorded. Statistical analysis is performed using IBM SPSS 25.
RESULTS: Among 195 subjects with proximal ureteric stones who underwent ESWL along with adjunctive therapy of tamsulosin showed an efficacy of 85.1%. The stones <10mm and ≥ 10mm were compared revealing efficacy of 93% and 75%, respectively (p-value 0.001). 84% of smaller stones had expulsion time within 2 weeks and 75% of larger stones had expulsion time within 4 weeks.
CONCLUSION: These data support the effectiveness of adjuvant therapy with tamsulosin after extracorporeal shockwave lithotripsy in proximal ureteric stones, especially small stones. The increase in the passage of residual fragments of stone improves the clearance rate. The limitation of this study is that the complication of this therapy is not considered; otherwise, it is the non-invasive management of post-ESWL therapy that resolves the misery of the patients.
KEYWORDS: Extracorporeal Shockwave Lithotripsy (ESWL), Tamsulosin, Proximal Ureteric Stone, Adjuvant therapy, Expulsion time