TITLE:
Effectiveness of Medical Management in Spontaneous Expulsion of Lower Ureteral Calculi: A Prospective Study
AUTHORS:
Azher Mushtaq, Sheikh Imran Farooq, Malik Suhail Ahmad, Fahad ul Islam Mir, Yassar Arafat
KEYWORDS:
Tamsulosin, KUB, Stone, Ureteric Calculi
JOURNAL NAME:
Surgical Science,
Vol.7 No.7,
July
25,
2016
ABSTRACT: Purpose: We
evaluated the efficacy of combined drug therapy with alpha1-adrenergic
antagonist tamsulosin and corticosteroid deflazocort for conservative expulsive
therapy in patients with lower ureteric calculi. Materials and Methods: A total
of 100 consecutive symptomatic patients with stones located in the Lower ureter
were selected for the study who received oral tamsulosin 0.4 mg daily for 4
weeks and deflazocort 30 mg daily for 10 days and diclofenac IM/Oral on demand.
Ultrasound follow-up and
medical visits and X ray KUB were performed weekly for 4 weeks. Stone passage
rate and time, pain episodes and endoscopical intervention were evaluated.
Results: The stone expulsion rate was 87.8%. Mean stone size was 6.5 ± 2.14 mm.
Mean expulsion time was 8 ± 1.84 days. Mean pain episodes were 1.50 ± 0.87
days. 11 patients needed intervention for stone retrieval. There was no
statistically significant difference between the expulsion rates of right and
left ureteral stones (P value = 0.31). Conclusions: Medical therapy with a combination of α1 adrenergic blocker and corticosteroid achieve good
stone expulsion rates, lower pain episodes and should be considered in all
patients with lower ureteral stones of size less than 10 mm who are not having
any contraindications for medical therapy.