Abstract:

Objective To investigate the efficacy and safety of tamsulosin combined with pethidine in the treatment of ureteral calculi during pregnancy. Methods Sixty-four pregnant women with ureteral calculi (renal colic for the first time) were divided into tamsulosin combined with pethidine group (n=26) and pethidine group (n=38). The degree of pain was evaluated by visual analogue scale (VAS) 48 h before and after treatment in two groups. B ultrasound was performed in 1 month after the end of pregnancy, YAG laser lithotripsy was carried out for those with residual stone, and stone clearance rate and operation rate were compared between two groups. Results In tamsulosin combined with pethidine group, 25 patients experienced pain relief, and the other 1 patient needed another dose of pethidine hydrochloride. In pethidine group, 24 patients achieved pain relief after treatment (double J stent was inserted in 1 patient), and the other 14 patients needed another dose of pethidine hydrochloride (double J stent was inserted in 4 patients). VAS decreased by 6.7±0.3 and 5.0±0.6 in tamsulosin combined with pethidine group and pethidine group respectively, and there were significant differences between them (P<0.05). At the end of pregnancy, the stone clearance rate in tamsulosin combined with pethidine group was significantly higher than that in pethidine group (96.2% vs 63.2%, P<0.01), and the stone clearance rates in middle or lower segment of ureter in tamsulosin combined with pethidine group were significantly higher than those in pethidine group (100% vs 50%, P<0.05; 100% vs 72.2%, P<0.05). The operation rate in tamsulosin combined with pethidine group was significantly lower than that in pethidine group (3.8% vs 31.6%, P<0.01). Conclusion For patients with renal colic due to ureteral calculi during pregnancy, tamsulosin combined with pethidine may provide favorable pain relief ratio and stone clearance rate, especially in middle or lower ureteral segment.

Key words: pregnancy, urinary calculi, treatment