Determine the Effectiveness of Low Dose Tamsulosin as a Medical Expulsive Therapy in Patients with Lower Ureteric Stones

Introduction: The human ureter contains a high number of α-adrenergic receptors, especially α1d -receptors at the lower part of the ureter. Tamsulosin is a combined α1a- and α1d- selective adrenergic antagonist that is an alternative to other medications, such as calcium channel blockers, corticosteroids, and analgesic and anti-inflammatory drugs, for the treatment of distal ureteric stones.Objective: To determine the effectiveness of low dose tamsulosin as a medical expulsive therapy in patients with lower ureteric stones.Setting: Department of Urology, Liaquat University of Medical and Health Sciences Jamshoro.Study design: Randomized controlled trial.Duration of study: 6 monthsSubjects and methods: All patients with either gender, age range 30-60 years and stone size 4-10 mm in the lower 1/3rd of the ureter determined on ultrasound were enrolled. Group A patients was offered low dose tamsulosin (0.2 mg) one tablet daily in the morning for a maximum of 4 weeks and group B served as control. The final outcome was measured at the end of 4th week of treatment. Patients were instructed to note the time and the date of expulsion of stone. Absence of echoic shadows on lower 1/3rd of ureteric line on ultrasound was taken as effectiveness (expulsion of stone).Results: In control group mean age was 45.52 ± 6.70 years whereas in low dose Tamsulin mean age was 46.72 ± 6.73 years. Frequency of male was higher in both control and low dose Tamsulin group, i.e. 39 (78%) and 21 (42%) respectively. In control group effectiveness was found 3 (6%) patients whereas in low dose Tamsulin group effectiveness was found in 47 (94%). Conclusion: In our study the effectiveness of low dose tamsulosin as a medical expulsive therapy in patients with lower ureteric stones was higher as compared to control.