Role of Tamsulosin in Treatment of Patients with Steinstrasse Developing After Extracorporeal Shock Wave Lithotripsy

Objectives: To evaluate whether tamsulosin, as an alpha(1)-blocker, was effective for the treatment of steinstrasse in the lower ureter after shock wave lithotripsy.

Methods: A total of 67 patients (43 men and 24 women) with steinstrasse in the lower portion of the ureters were randomly divided into two groups. Only hydration and tenoxicam (20 mg orally once daily) was given to group 1 (35 patients). Group 2 (32 patients), was also given tamsulosin (0.4 mg daily). All patients were reevaluated and questioned about the number of episodes and severity of ureteral colic and the rates of spontaneous resolution of steinstrasse 6 weeks after beginning treatment. They were asked to score the severity of pain according to a visual analog scale.

Results: In 23 (65.7%) of 35 patients in group 1 and in 24 (75%) of 32 patients in group 2, steinstrasse resolved during the first 6 weeks. The resolution rates were not significantly different (P >0.05) between groups 1 and 2. Group 1 had more ureteral colic episodes than did group 2 while passing their stones. This difference was statistically significant (P <0.01). Group 1 patients reported significantly greater (P <0.001) visual analog scale scores than did group 2 patients.

Conclusions: The addition of tamsulosin to conservative treatment seemed to be beneficial in terms of the reduced number of ureteral colic episodes and the severity of pain in the patients who developed steinstrasse after shock wave lithotripsy.