Does Tamsulosin Has A Role in The Conservative Treatment of Appendicitis

Abstract

Objectives: To define the value of Tamsulsine drug addition to antibiotics (Cefitrixon and Metronidazole) in conservative treatment of non-perforated acute appendicitis. Methods: The design of this study is prospective clinical study. Study performed in Al-Jumhuri Teaching Hospital, January 2010-January 2012. 102 adult patients 74 male and 28 females between 17-45 years of age complaining from acute appendicitis treated in our unit they were well interrogated and clinically examined, all are send for general urine examination, ultrasound, C-reactive protein and chest X-ray. Those who discovered to have perforated appendicitis or complications were excluded from the study. Then the patients were divided into two equal groups(A and B). Group A: were given 500 mg Ceftriaxone and 500 mg Metronidazole, both intravenously twice daily. Group B: were given in addition to the previous antibiotics regime Tamsulsine 0.4 mg orally once daily. If the patient showed good signs of recovery in the first 24 hours of the treatment, we continue the treatment for the further 5 days. If not we do immediate appendicectomy. Follow up for 4 months done to those who were discharged. Results: During the period of the study, Group A: 41 patients (out of 52) 78.89% got good signs of recovery and relieved within the first 24 hours, while 10 patients needed exploration and appendicectomy. Group B: 49 patients (out of 52)94.23% gave good signs of recovery and relieved within the first 24 hours only 2 patients needed exploration and appendicectomy(no response). Our index of recovery are decreasing and disappearance of abdominal pain and tenderness, good appetite and positive bowel sound. Those who were discharged after conservative treatment are followed for 4 months for recurrence of appendicitis we got 5 patients who got recurrence and needed appendicectomy in group A, while we got only 3 in group B. Conclusion: Conservative treatment of acute appendicitis with antibiotic is now accepted in many centers. Tamsulsine drug if added to the antibiotic treatment is safe and convey better and fast recovery of the patients and less recurrence rate.