Abstract

ROLE OF MEDICAL EXPULSIVE THERAPY IN LOWER URETERAL CALCULUS

Dr. Ashok Saini, *Dr. Mayank Jain and Dr. Anant Kamath

ABSTRACT

Introduction: Medical expulsive therapy (MET) has been proven to enhance stone expulsion rate, decrease stone expulsion time for lower ureteric stones. While alpha-blockers are currently recommended monotherapy, corticosteroids are useful adjunct in MET. Objectives: To determine efficacy and safety of MET by evaluating the role of corticosteroid Deflazacort in combination with alpha blocker Tamsulosin in medical management of symptomatic lower ureteric stones. Methods: 105 patients of symptomatic lower ureteric calculus of 5mm to 10 mm in diameter were included in the study. Patients were divided in to 3 groups; Group A has 35 patients receiving only analgesics as control group, Group B had 35 patients receiving Tamsulosin and Group C 35 patients who received Tamsulosin and Deflazacort combination. The maxmimum treatment duration was of 28 days. Results: The stone expulsion rate was 17/35(48.30%), 26/35(74.60%), 28/35(80%) in groups A,B and C respectively. Stone expulsion rate was significant between groups A&B, A&C but not between group B& C. The mean expulsion time was significantly less in group C compare to group A & B. Conclusion: MET with Tamsulosin and Deflazocort has higher stone expulsion rate compared to tamsulosin or placebo alone.The combination also has faster stone expulsion and it proved to be safe and effective.

Keywords: MET-Medical expulsive therapy, Alpha blocker Tamsulosin, Deflazacort, Lower ureteric calculus.