Kaan KARAMIK, Mehmet KISAARSLAN, Hakan ANIL, Nihat ATEŞ

Distal üreter taşı olan hastalarda taş düşürmede medikal ekspulsif tedavi olarak tamsulosinin silodosine karşı etkinliği: Geriye dönük tek merkezli bir çalışma

Amaç: Bu çalışma ile, semptomatik komplike olmayan distal üreter taşı olan hastalarda medikal ekspulsif tedavi olarak tamsulosin ve silodosinin etkinliği karşılaştırılması amaçlandı. Gereç ve Yöntemler: Haziran 2019 ile Ocak 2022 tarihleri arasında 4-10 mm boyutlarında distal üreter taşı olan ve medikal ekspulsif tedavi uygulanan erişkin hastaların verileri geriye dönük olarak belgelendi. Hastalar iki gruba ayrıldı. Grup 1‘deki hastaları 4 mg silodosin tedavisi verilen ve Grup 2’deki hastaları 0,4 mg tamsulosin verilen hastalar oluşturdu. Tedaviye maksimum 3 hafta devam edildi. Taş düşürme oranı, taş düşürme süresi, taş yükü ve taş boyutu kaydedildi. Yardımcı tıbbi tedavi olarak tamsulosin ve silodosinin etkinliği belirlendi. Bulgular: Çalışmaya toplam 152 hasta dahil edildi. Demografik veriler iki grup arasında benzerdi. 116 (%76,3) hasta takip sonunda taşsızdı. Grup 1’ de 47 hastada (%73,4), Grup 2’ de 69 hastada (%78,4) taşın düştüğü hesaplandı (P = 0,477). Çok değişkenli analizde taşın üreterovezikal bileşkeye olan mesafesi, başarılı taş düşürme ile anlamlı şekilde ilişkiliydi (P=0,032). Sonuç: Distal üreter taşları için medikal ekspulsif tedavi olarak tamsulosin ve silodosin arasında anlamlı bir üstünlük yoktu. Taşın üreterovezikal bileşkeye olan mesafesi, çok değişkenli analizde taş düşürülmesinin tek bağımsız belirleyicisiydi.

Anahtar Kelimeler:

Medikal ekspulsif tedavi, üreter taşı, silodosin, tamsulosin

Efficacy of tamsulosin versus silodosin as medical expulsive therapy on stone expulsion in patients with distal ureteral stone: A retrospective single center study

Objective: This study aimed to compare the efficacy of tamsulosin and silodosin as medical expulsive therapy in patients with symptomatic uncomplicated distal ureteric stones. Material and Methods: The data of adult patients who had distal ureteric stones in size between 4 and 10 mm and were treated with medical expulsive therapy between June 2019 and January 2022 were retrospectively documented. Patients were divided into two groups. Patients in Group 1 received silodosin 4 mg, and Group 2 received tamsulosin 0.4 mg. Therapy was given for a maximum of 3 weeks. Stone expulsion rate, time to stone expulsion, stone burden, and stone size were recorded. The efficacy of tamsulosin and silodosin as adjunctive medical therapy was determined. Results: A total of 152 patients were included in the study. Demographic profiles were comparable between the 2 groups. 116 (76.3%) patients were stone-free at the end of the follow-up. The stone expulsion rate was calculated in 47 patients (73.4%) in Group 1, and 69 patients (78.4%) in Group 2 (P = 0.477). The distance of the stone to the ureterovesical junction was significantly associated with successful stone expulsion in multivariate analysis (P=0.032). Conclusion: There was no significant superiority between tamsulosin and silodosin as medical expulsive therapy for distal ureteral stones. The distance of the stone to the reterovesical junction was the only independent predictor of stone expulsion in multivariate analysis.

Keywords:

Medical expulsive therapy, ureteral stone, silodosin, tamsulosin,

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