OBJECTIVETo evaluate the efficacy of alpha1-adrenergic antagonist in the medical management of lower ureteral stone with extracorporeal shock wave lithotripsy (ESWL).

METHODSA total of 80 patients with stone located in lower ureter were randomly divided into two groups. Group 1 served as control and group 2 received tamsulosin (0.4 mg, once daily) after ESWL. All patients were observed for 2 weeks and asked to compile a diary about renal colic, stone expulsion, use of analgesic drugs, and side effects of medical therapy.

RESULTSDuring 2 weeks, stones were expulsed in 18 patients (45.0%) of group 1 and in 31 patients (77.5%) of group 2. The expulsion rate between group 1 and group 2 was significantly different (P < 0.01). Eight patients (20.0%) in group 1 and 2 patients (5.0%) in group 2 experienced renal colic relapse within 2 weeks and were administered with analgesics (P < 0.05). No side effect in group 1 was reported, except that 2 patients in group 2 complained of slight dizziness.

CONCLUSIONSTamsulosin (alpha1-adrenergic antagonist) can improve the stone-free rate of lower ureteral stones after ESWL and reduce the relapse of renal colic. As a safe and effective agent, it can be regarded as an auxiliary clearance method after ESWL for lower ureteral stones.