Archive \ Volume.13 2022 Issue 4

The Effective Medical Expulsion Therapy for Distal Ureteric Stones

, , , ,

Abstract

The lifetime risk of developing genitourinary stone is 5-12%.  Males are more prone to calculus formation as compared to females. The data for the Indian population suggests that 12% of the people develop urinary calculi and half of them end up with the loss of kidney functions. Symptomatic urolithiasis represents a common condition observed by surgeons and urologists in an emergency setting. The lower third/distal ureter is the most common site for the ureteric calculus. We did this study to evaluate the efficacy of tamsulosin in the management of distal ureteral stones when administered alone or in conjugation with low-dose corticosteroid (Deflazacort) over the watchful waiting therapy using only non-steroidal anti-inflammatory drugs. In this study the male-female ratio was 3:1. The mean age group of females was 36.04 and in males was 38.14. The mean size of stone in various groups was around 6mm. the left side of ureter was more symptomatic than the right side. Mean day use of NSAID was least in group B. Group B was the most benefitted by the medical expulsion therapy. We conclude that medical expulsive therapy is safe and effective for symptomatic and non-complicated distal ureteral stone. In addition, Tamsulosin used on its own as a medical expulsive therapy can be considered an alternative treatment in those patients who are unsuitable for steroid therapy. Deflazacort given even in low dose has the same effect as that of larger doses.


Downloads: 63
Views: 83

How to cite:
Vancouver
Ambardekar R, Dhangar SP, Syed AA, Vaidya S, Shengal M. The Effective Medical Expulsion Therapy for Distal Ureteric Stones. Arch Pharm Pract. 2022;13(4):92-6. https://doi.org/10.51847/UygHWTyiZ3
APA
Ambardekar, R., Dhangar, S. P., Syed, A. A., Vaidya, S., & Shengal, M. (2022). The Effective Medical Expulsion Therapy for Distal Ureteric Stones. Archives of Pharmacy Practice, 13(4), 92-96. https://doi.org/10.51847/UygHWTyiZ3

Download Citation
References

1.        Yasui T, Okada A, Hamamoto S, Ando R, Taguchi K, Tozawa K, et al. Pathophysiology-based treatment of urolithiasis. Int J Urol. 2017;24(1):32-8.

2.        Ding H, Ning Z, Dai Y, Shang P, Yang L. The role of Silodosin as a new medical expulsive therapy for ureteral stones: a meta-analysis. Ren Fail. 2016;38(9):1311-9. 

3.        Chung MJ. Urolithiasis and nephrolithiasis. JAAPA. 2017;30(9):49-50.

4.        Ali Q, Khan S, Patel G, Jaiswal K. Medical expulsive therapy: a cost-effective evidence-based definitive treatment for ureteric stones. Int Surg J. 2020;7(9):2879-82.

5.        Abdelaziz AS, Kidder AM. Tamsulosin therapy improved the outcome of ureterorenoscopy for lower ureteral stones: A prospective, randomised, controlled, clinical trial. Afr J Urol. 2017;23(2):148-53.

6.        Ye Z, Zeng G, Yang H, Tang K, Zhang X, Li H, et al. Efficacy and Safety of Tamsulosin in Medical Expulsive Therapy for Distal Ureteral Stones with Renal Colic: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial. Eur Urol. 2018;73(3):385-91. 

7.        Sinha AR, Siwach V. Evaluation of the efficacy of tamsulosin and deflazacort versus tamsulosin alone in expulsion of lower ureteric stones in a tertiary center. Int J Sci Stud. 2019;6(10):68-72.

8.        Nour HH, Kamel AI, Elmansy H, Badawy MH, Shabana W, Abdelwahab A, et al. Pneumatic vs laser lithotripsy for mid-ureteric stones: Clinical and cost effectiveness results of a prospective trial in a developing country. Arab J Urol. 2020;18(3):181-6. 

9.        Volkin D, Shah O. Complications of ureteroscopy for stone disease. Minerva Urol Nefrol. 2016;68(6):570-85.

10.      Campschroer T, Zhu X, Vernooij RW, Lock MT. Alpha-blockers as medical expulsive therapy for ureteral stones. Cochrane Database Syst Rev. 2018;4(4):135-61.

11.      Ramadhani MZ, Kloping YP, Rahman IA, Yogiswara N, Soebadi MA, Renaldo J. Silodosin as a medical expulsive therapy for distal ureteric stones: A systemic review and meta-analysis. Indian J Urol. 2023;39(1):21-6.

12.      Phukan M, Sarma D, Puthenveetil RT, Barua SK, Baruah SJ. Alpha-Adrenergic Blockers with or without Deflazacort for the Expulsion of a Lower Ureteric Calculus ≤ 10 mm: A Comparative Study. UroToday Int J. 2013;6(5):62. doi:10.3834/uij.1944-5784.2013.10.09


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.