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.