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Category: Volume 05 Issue 10 October 2017
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Title: Alfuzosin versus Tamsulozin in the Treatment of Patients with Distal Ureteral Calculus - Prospective, Randomised, Comparative Study

Authors: Dr Ravi Veerappan, Dr Ashok Kumar R., Dr Senthil Nathan K, Dr Jayaprakash Narayanan K, Rajkumar R.

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.46

Abstract

Introduction: Ureteral calculus 4mm or smaller will usually pass spontaneously. Conservative medical treatment to be applied first. The simple waiting approach may result in complication. So, the simple watchful waiting approach is extended by pharmacotherapy. The drugs used as medical expulsive therapy are calcium channel blockers, alpha blockers, corticosteroids. 

Aim: We evaluated and compared the efficacy of Tamsulozin and Alfusozin in the medical treatment of symptomatic uncomplicated distal ureteric calculus.

Materials and Methods: A total of 150 patients with distal ureteric calculus of ≤ 10mm were randomly divided into 3 groups. Group A patients ( n=50) received  placebo ,Group B patients (n=50)received Tamsulozin 0.4mg/day, Group C patients (n=50) received Alfuzosin 10mg/day. All patients received Diclofenac sodium 50 mg on demand. Follow up was done on weekly basis for30 days.

Results: The mean calculus size was comparable in the 3 groups (6.98±1.6mm, 6.34±1.7mm, 6.7±1.5mm, respectively). The calculus expulsion rate was 32%, 72%, 74%.  A statistically  significant difference was noted between group A and B(p=0.00006) and between A and C (p=0.00003), whereas no significant difference between Band C. The mean calculus expulsion time was(8.63±3.24, 7.75±3.14, 8.57±4,52days respectively). There was no statistical difference was observed between the groups( p=0.5961).The analgesic requirement was 6.60± 1.82 doses in group A, 3.86± 2.51doses in group B, and 4.18±3.02 in group C. Analgesic requirement was more in group A than in group B and C. No severe complications which require suspension of therapy due to drugs were found (2 patients retrograde ejaculation in group B , few days of  dizziness 1 patient in group C).

Conclusion: The use of Tamsulozin or Alfusozin as medical expulsive therapy for lower ureteric calculus proved to be safe and effective. Moreover, alfusozin did not have any significant benefit over tamsulozin.

Keywords:  Ureteric calculi;Tamsulozin;  Alfuzosin.

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Corresponding Author

Dr V.Ravi

Assistant Professor, Department of urology, Thanjavur Medical College