Ahmed Mahmoud Hasan, Amr Alameldeen Ahmed, Reham Farouk Sayed, Mostafa AbdelRazek
{"title":"Efficacy of cetirizine, tamsulosin and their combination as medical expulsive therapy for distal ureteral stones: a prospective randomized study.","authors":"Ahmed Mahmoud Hasan, Amr Alameldeen Ahmed, Reham Farouk Sayed, Mostafa AbdelRazek","doi":"10.1159/uin/aewag046","DOIUrl":null,"url":null,"abstract":"<p><p>Background The management of ureteral stones, particularly those measuring less than 10 mm, has garnered considerable attention in urological research, with the goal of enhancing non-invasive treatment methods. Medical expulsive therapy is notable for its low invasiveness and cost.</p><p><strong>Objectives: </strong>To assess the efficacy and safety of tamsulosin alone, cetirizine alone, as well as their combination in treating distal ureteric stones sized 5-10 mm.</p><p><strong>Methods: </strong>Between March 2021 and March 2024, patients presented with lower ureteral stones 5-10 mm were randomly assigned to four groups: group A (121 patients) took tamsulosin 0.4 mg; group B (120 patients) took cetirizine 5 mg; group C (119 patients) took a combination of tamsulosin 0.4 mg and cetirizine 5 mg; and group D (120 patients) received analgesics on demand as a control group. We evaluated stone passage rates, time required for stone expulsion, total analgesic dosage, and any recorded side effects. All outcomes were recorded and analyzed accordingly.</p><p><strong>Results: </strong>Group C exhibited the highest rate of stone expulsion among all groups (85.8% vs. 67%, 55%, and 25% in groups A, B, and D respectively, p = 0.0001). Group C had a substantially shorter time required for stone expulsion in comparison with groups A, B, and D (13.15 ± 5.3 days vs. 14.95 ± 6.95, 17.57 ± 6.21, and 20.94 ± 5.58 days respectively, p < 0.0001). A statistically significant reduction in the total analgesic requirements was demonstrated in group C (p < 0.0001). Except for retrograde ejaculation which was evident in groups A and C (40 %, 37.7 % respectively versus 0% in the other groups, p < 0.0001), no substantial variations regarding the side effects were observed among the groups.</p><p><strong>Conclusions: </strong>Combined therapy with tamsulosin and cetirizine significantly improves stone expulsion rate, shortens expulsion time, and reduces analgesic requirements compared with either therapy alone.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2000,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologia Internationalis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/uin/aewag046","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background The management of ureteral stones, particularly those measuring less than 10 mm, has garnered considerable attention in urological research, with the goal of enhancing non-invasive treatment methods. Medical expulsive therapy is notable for its low invasiveness and cost.
Objectives: To assess the efficacy and safety of tamsulosin alone, cetirizine alone, as well as their combination in treating distal ureteric stones sized 5-10 mm.
Methods: Between March 2021 and March 2024, patients presented with lower ureteral stones 5-10 mm were randomly assigned to four groups: group A (121 patients) took tamsulosin 0.4 mg; group B (120 patients) took cetirizine 5 mg; group C (119 patients) took a combination of tamsulosin 0.4 mg and cetirizine 5 mg; and group D (120 patients) received analgesics on demand as a control group. We evaluated stone passage rates, time required for stone expulsion, total analgesic dosage, and any recorded side effects. All outcomes were recorded and analyzed accordingly.
Results: Group C exhibited the highest rate of stone expulsion among all groups (85.8% vs. 67%, 55%, and 25% in groups A, B, and D respectively, p = 0.0001). Group C had a substantially shorter time required for stone expulsion in comparison with groups A, B, and D (13.15 ± 5.3 days vs. 14.95 ± 6.95, 17.57 ± 6.21, and 20.94 ± 5.58 days respectively, p < 0.0001). A statistically significant reduction in the total analgesic requirements was demonstrated in group C (p < 0.0001). Except for retrograde ejaculation which was evident in groups A and C (40 %, 37.7 % respectively versus 0% in the other groups, p < 0.0001), no substantial variations regarding the side effects were observed among the groups.
Conclusions: Combined therapy with tamsulosin and cetirizine significantly improves stone expulsion rate, shortens expulsion time, and reduces analgesic requirements compared with either therapy alone.
期刊介绍：
Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.
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