Efficacy of Tamsulosin Alone and Combination with Tolterodine in Managing Intramural Ureteric Stone
Keywords:tamsulosin, tolterodine, ureteric calculi, medical expulsive therapy
Objective: To compare the efficacy of Tamsulosin alone and combination with in managing intramural ureteric stone in order to obviate the need for surgical treatment and related complications
Methodology: A total of 104 patients with distal ureteral stones were included in the study (90 men and 14 women) age ranging from 19 to 59 years. Those with stones less than 10 mm and allowing urinary flow were included in the study. Asymptomatic or incidentally found Intramural Ureteric Stone, Ureteric stone along with kidney stone, Presence of urinary sepsis, Chronic kidney disease stage 4 or stage 5, Pregnancy, Patients currently taking an α-blocker/Antimuscrinic agents, Gross hydronephrosis, Diabetes were excluded from the study. After randomization, divided 2 groups and patients were given respective drugs. Group 1 patients received Tamsulosin 0.4 mg/day, group 2 patients received Tamsulosin 0.4 mg/day plus 2 mg (twice a day).
Results: The mean days of stone expulsion was 20.05± 6.11 and 10.41±4.63 days in group 1 and 2, respectively which was significantly shorter in group 2 (p-value, <0.001). Overall in 43 (82.6%) patients in group 2 and 34 (65.3%) cases in group 2, stone was expulsed before 28 days. The expulsion of intramural ureteric stones were more observed in patients treated with combination therapy (group 2) than tamulosin alone therapy. The mean duration of expulsion of stones was also found significantly shorter the combination therapy group.
Conclusion: In the present study, the expulsion of intramural ureteric stones were more observed in patients treated with combination therapy (group 2) than tamulosin alone therapy. It is concluded that Tamsulosin combined with has a better effect in terms of intramural ureteric stone expulsion.
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