EYÜP VELİ KÜÇÜK, Abdurrahman İNKAYA, Ahmet TAHRA, Ahmet BİNDAYI, Fikret Fatih ÖNOL

Distal üreter taşı tedavisinde tamsulosin ve silodosin tedavilerinin karşılaştırılması

Amaç: Renal kolik ile başvuran ve distal üreter taşı tespit edilen hastaların tedavisinde takip ve medikal ekspulsif tedavi amacıyla kullanılan tamsulosin 0.4 mg ve silodosin 8 mg tedavisinin karşılaştırılması. Gereç Yöntem: Ocak 2014-Aralık 2015 tarihleri arasında akut renal kolik ile başvuran ve bilgisayarlı tomografide en uzun çapı 4 mm ile 9 mm arasında üreter iliak damarlar çaprazının altında lokalize taşı olan 184 hasta çalışmaya dahil edildi. Analjezik ihtiyacı olduğunda 25 mg deksketoprofen kullanan 59 hasta takip grubu , günlük 0.4 mg tamsulosin kullanan ve analjezi ihtiyacı halinde 25 mg deksketoprofen kullanan 64 hasta tamsulosin grubu , günlük 8 mg silodosin ve analjezi ihtiyacı halinde 25 mg deksketoprofen kullanan 61 hasta silodosin grubu retrospektif olarak 3 grupta değerlendirildi. Hastalar 4 hafta süresince haftalık olarak takip edildi. Taş düşürme oranları, taşın düşürülme süresi, analjezik tedavi ihtiyacı, ilaçlara bağlı yan etkiler raporlandı. Bulgular: Taş düşürme oranları takip grubunda % 63, tamsulosin grubunda % 77 ve silodosin grubunda %82 olarak belirlendi. Hastaların analjezik ihtiyacı, renal kolik atakları ve taş düşürme süreleri silodosin ve tamsulosin gruplarında benzer ve takip grubunda daha fazla tespit edildi. İlaçlara bağlı ciddi bir yan etki görülmedi. Sonuç: Medikal ekspulsif tedavi komplike olmayan, özellikle distal üreter taşında önerilen bir tedavi seçeneğidir. Tamsulosin 0.4 mg ve silodosin 8 mg distal üreter taşı tedavisinde, taş düşürme oranlarını istatistiksel anlamlı olarak arttıran ve ağrı epizodlarını ve analjezik kullanımını azaltabilen benzer etkinlik ve güvenlikte olan tedavilerdir

Anahtar Kelimeler:

Medikal ekspulsif tedavi, alfa bloker, üreter taşı

Comparison of tamsulosin and silodosin in distal ureteral stones

Purpose: To evaluate the effect of tamsulosin 0.4 mg and silodosin 8 mg for the medical expulsive treatment in distal ureteral stones. Material and Methods: Between January 2014 and December 2015, 184 patients with acute renal colic who were diagnosed as distal ureteral stone 4 to 9 mm by computarized tomography were evaluated retrospectively. Patients were divided into three groups: first group follow-up group n=59 took dexketoprofen 25 mg on-demand, second group tamsulosin group n=64 took tamsulosin 0.4 mg daily and dexketoprofen 25 mg on-demand, third group silodosin group n=61 took silodosin 8 mg daily and dexketoprofen 25 mg on-demand. All patients were observed for 4 weeks. Stone expulsion rates, expulsion time, need for analgesics and adverse events were recorded. Results: Stone expulsion rates were 63% in the follow-up group, 77% in the tamsulosin group and, 82% in the silodosin group. Need for analgesics, pain episodes, expulsion time were higher in follow-up group than the other two groups. No serious adverse events was recorded. Conclusion: Medical expulsive treatment is an option for uncomplicated distal ureteral stones. A statistically significant increase in the stone expulsion rate and reduction for use of analgesics can be achieved with tamsulosin 0.4 mg and silodosin 8 mg in patients with distal ureteral stones.

Keywords:

Medical expulsive treatment, alfa blocker, ureteral stone,

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