Enhancing Stone Clearance: The role of Tamsulosin as an adjunct to Extracorporeal Shock Wave Lithotripsy.

Abstract

Background: Urolithiasis affects 12% of the global population and is commonly treated with extracorporeal shock wave lithotripsy (ESWL) due to its efficacy, noninvasiveness, and low morbidity. Factors influencing renal stone clearance include ureteral dynamics, fragmentation efficiency, and calyceal anatomy. The use of alpha-blockers post-ESWL is hypothesized to improve stone clearance rates.

Methodology: A prospective cohort study was conducted at Sindh Institute of Urology and Transplantation (SIUT) from June 6, 2018, to December 5, 2018. The study enrolled 120 individuals aged 18–70 years diagnosed with renal stone disease, with stone sizes ranging from 0.5 to 2.0 cm. Patients were randomly assigned to receive either placebo or tamsulosin immediately following ESWL, in addition to standard therapy. Stone clearance rates were assessed over a two-week follow-up period.

Results: Among the study participants, renal stones were present in 61 (50.83%) patients on the left side and 59 (49.17%) on the right side. Stone clearance rates were significantly higher in the study group (96.6%) compared to the control group (85.0%) (p=0.027).

Conclusion: Administration of alpha-blockers, specifically tamsulosin, following ESWL appears effective in enhancing the expulsion rate of renal stones.