***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE We evaluated the effect of the alpha-blocker tamsulosin on stone clearance , analgesic requirements and steinstrasse in shock wave lithotripsy for solitary renal and ureteral calculus . MATERIAL S AND METHODS A prospect i ve , double-blind , r and omized placebo controlled study was performed during 1 year involving 60 patients with a solitary renal or ureteral calculus undergoing shock wave lithotripsy .  The control group ( 30 ) received 0.4 mg tamsulosin and the study group ( 30 ) received placebo daily until stone clearance or for a maximum of 30 days . An oral preparation of dextropropoxyphene hydrochloride and acetaminophen was the analgesic used on an on-dem and basis . The parameters assessed were stone size , position , clearance time , effect on steinstrasse and analgesic requirement . RESULTS The overall clearance rate was 96.6 % ( 28 of 29 ) in the study group and 79.3 % ( 23 of 29 ) in the control group ( p = 0.04 ) . With larger stones 11 to 24 mm the difference in the clearance rate was significant ( p = 0.03 ) but not so with the smaller stones 6 to 10 mm ( p = 0.35 ) . The average dose of analgesic used was lower with tamsulosin than with controls , without statistical significance . Steinstrasse resolved spontaneously in the tamsulosin group whereas 25 % ( 2 of 8) required intervention in the placebo group . There was no difference between the 2 groups with regard to age , stone size or location . CONCLUSIONS The alpha-blocker tamsulosin seemed to facilitate stone clearance , particularly with larger stones during shock wave lithotripsy for renal and ureteral calculus . It also appeared to improve the outcome of steinstrasse .  Tamsulosin may have a potential role in routine shock wave lithotripsy OBJECTIVES To design a r and omized , no-treatment , controlled , prospect i ve study to determine whether the administration of tamsulosin , as adjunctive medical therapy , increases the efficacy of one extracorporeal shock wave lithotripsy ( ESWL ) session to treat renal stones and decreases the use of analgesic drugs after the procedure . METHODS A total of 130 patients underwent a single ESWL session to treat solitary radiopaque renal stones 4 to 20 mm in diameter . After treatment , all patients were r and omly assigned to receive our st and ard medical therapy alone ( controls ) or in association with 0.4 mg tamsulosin daily for a maximum of 12 weeks . All 130 patients were followed up for 3 months or until an alternative treatment was given . RESULTS Of the 130 patients , 78.5 % of those receiving tamsulosin and 60 % of controls had achieved clinical success at 3 months ( P = 0.037 ) . When we stratified patients according to stone size , for those with a stone size larger than 10 mm , the success rate was significantly greater in the tamsulosin group ( P = 0.028 ) . Renoureteral colic occurred in 76.9 % of patients treated with st and ard therapy but in only 26.1 % of those receiving tamsulosin ( P < 0.001 ) . The mean cumulative diclofenac dose was 375 mg per patient in the tamsulosin group and 675 mg per patient in the control group ( P < 0.001 ) . CONCLUSIONS The results of our study have demonstrated that tamsulosin therapy , as an adjunctive medical therapy after ESWL , is more effective than lithotripsy alone for the treatment of patients with large renal stones and is equally safe . In addition , our results also indicated that adjunctive treatment with tamsulosin could decrease the use of analgesic drugs after ESWL Extracorporeal shock wave lithotripsy ( ESWL ) is currently considered one of the main treatments for ureteral stones . Some studies have reported the effectiveness of pharmacologic therapies ( calcium antagonists or alpha-blockers ) in facilitating ureteral stone expulsion after ESWL . We prospect ively evaluated the efficacy , after ESWL , of nifedipine on upper-middle ureteral stones , and tamsulosin on lower ureteral stones , both associated to ketoprofene as anti-edema agent . From January 2003 to March 2005 we prospect ively evaluated 113 patients affected by radiopaque or radiolucent ureteral stones . Average stone size was 10.16 ± 2.00 mm ( range 6–14 mm ) . Thirty-seven stones were located in the upper ureter , 27 in the middle ureter , and 49 in the lower ureter . All patients received a single session of ESWL ( mean number of shock waves : 3,500 ) by means of a Dornier Lithotripter S ( mean energy power for each treatment : 84 % ) . Both ultrasound and X-ray were used for stone scanning . After treatment , 63 of 113 patients were su bmi tted to medical therapy to aid stone expulsion : nifedipine 30 mg/day for 14 days administered to 35 patients with upper-middle ureteral stones ( group A1 ) and tamsulosin 0.4 mg/day for 14 days administered to 28 patients with stones located in the distal ureter ( group A2 ) . The remaining 50 patients were used as a control group ( 29 upper – middle ureteral stones — B1— and 21 lower ureteral stones — B2— ) , receiving only pain-relieving therapy . No significant difference in stone size between the groups defined was observed . Stone clearance was assessed 1 and 2 months after ESWL by means of KUB , ultrasound scan and /or excretory urography . A stone-free condition was defined as complete stone clearance or the presence of residual fragments smaller than 3 mm in diameter . The stone-free rates in the expulsive medical therapy group were 85.7 and 82.1 % for the nifedipine ( A1 ) and tamsulosin ( A2 ) groups respectively ; stone-free rates in the control groups were 51.7 and 57.1 % ( B1 and B2 , respectively ) . Five patients ( 14.3 % ) in group A1 , 5 ( 17.8 % ) in group A2 , 14 ( 48.3 % ) in group B1 and 9 ( 42.8 % ) in group B2 were not stone-free after a single ESWL session and required ESWL re-treatment or an endoscopic treatment . Medical therapy following ESWL to facilitate ureteral stone expulsion results in increased 1- and 2-month stone-free rates and in a lower percentage of those needing re-treatment . The efficacy of nifedipine for the upper-mid ureteral tract associated with ketoprofene makes expulsive medical therapy suitable for improving overall outcomes of ESWL treatment for ureteral stones OBJECTIVES To investigate the role of tamsulosin as an adjunct to management of  upper ureteric stones ( UUS ) with  extracorporeal shock wave lithotripsy  ( SWL ) . METHODS In this prospect i ve , r and omized , open label study , patients with single UUS ( for SWL ) were r and omly assigned into 2 groups based on whether they received 0.4 mg tamsulosin ( group A and B , respectively ) during treatment . Repeat SWL was performed at week 1 , 3 , and 5 after first session . Primary outcome variables were success rate and pain intensity . RESULTS A total of 40 patients ( 20 each group ) completed the requisite follow-up . Success rate was higher in group A after 1 SWL-session ( 55 % vs 25 % , respectively ; P = .05 ) . There was an insignificant trend of decreased number of days ( 30.7 + /- 19.7 vs 39.0 + /- 19.9 ; P = .19 ) , number of SWL sessions ( 1.6 vs 2.0 ; P = .10 ) , and pain experienced ( score on visual analog scale , 25.3 + /- 17.9 vs 38.3 + /- 28.0 , respectively ; P = .41 ) in group A. Three in group A and 6 in B developed steinstrasse ( P = .69 ) . Overall , 1 in group A required auxiliary procedures as compared with 3 in control group ( P = .60 ) . CONCLUSIONS Tamsulosin improves clearance rate of UUS after single SWL . However , it does not provide significant advantage in terms of decreasing pain associated with this treatment OBJECTIVES To evaluate whether alpha1-blockers have any impact on stone clearance in patients with lower ureteral stones who underwent either shock wave lithotripsy ( SWL ) or were followed up with st and ard hydration , analgesics , and anti-inflammatory treatment . METHODS A total of 78 patients ( 56 men and 22 women ) who had lower ureteral stones located at the distal 5 cm of the ureter were divided into four groups . The first group consisted of 30 patients ( 38.5 % ) with stones less than 5 mm ( range 3 to 5 ) who were r and omly divided into two subgroups . Group 1 consisted of 15 patients ( 19.2 % ) who were followed up with oral hydration and diclofenac sodium . Group 2 consisted of 15 patients ( 19.2 % ) who received tamsulosin 0.4 mg daily in addition to the st and ard regimens . The second two groups consisted of 48 patients ( 61.5 % ) with stones greater than 5 mm ( range 6 to 15 ) who underwent SWL . These patients were also r and omly divided between those who did not ( group 3 , n = 24 ) and those who did ( group 4 , n = 24 ) receive tamsulosin 0.4 mg daily . All patients were re-evaluated with plain abdominal x-rays and helical computed tomography 15 days after the beginning of treatment . RESULTS Of the 78 patients , 36 ( 46.2 % ) became stone free . The stone-free rate was 20 % , 53.3 % , 33.3 % , and 70.8 % for group 1 , 2 , 3 , and 4 , respectively . The best results were achieved in those who underwent SWL plus tamsulosin treatment ( group 4 ) . The differences between the stone-free rates for groups 3 versus 4 ( P = 0.019 ) and the tamsulosin versus control groups ( P = 0.0015 ) were statistically significant . CONCLUSIONS The addition of tamsulosin to conventional treatment seemed beneficial in terms of stone clearance of lower ureteral stones , and this effect was more evident for larger stones , especially when combined with SWL OBJECTIVE To evaluate the efficacy of alpha1-adrenergic antagonist in the medical management of lower ureteral stone with extracorporeal shock wave lithotripsy ( ESWL ) . METHODS A total of 80 patients with stone located in lower ureter were r and omly 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 . RESULTS During 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 . CONCLUSIONS Tamsulosin ( 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 Introduction : We assessed the efficacy of using an α-1A-specific blocker for improving the success rate in shock wave lithotripsy ( SWL ) for lower ureteral stones . Material s and Methods : This prospect i ve study was conducted from June 2005 to December 2006 and involved 107 patients . All the patients underwent SWL with the PCK Stonelith . The patients were r and omly divided into 3 groups : group 1 ( 34 patients ) received tamsulosin , group 2 ( 35 patients ) received terazosin , and group 3 ( 38 patients ) received placebo .  All patients were diagnosed by kidney-ureter-bladder X-ray , abdominal ultrasonography and intravenous urography . The number of colic episodes , lower urinary tract symptoms , analgesic dosage and days for spontaneous passage of the stones through the ureter were recorded by diary . Statistical analyses were performed using ANOVA , the χ2 test , Fisher ’s exact test and the non-parametric Wilcoxon 2- sample t test . Results : There were no differences between the groups regarding age , stone size , expulsion time and expulsion rate . The number of colic episodes and the analgesic dosage were significantly lower in group 1 compared with groups 2 and 
    Output:
    
In addition , a shorter expulsion time , lower analgesic requirements , fewer colic episodes and adverse effects were observed .
CONCLUSIONS Tamsulosin is a safe and effective therapy for renal and ureteral stones after SWL .