ÓÄÊ 616.16

Conservative Therapy for Distal Ureter Stones:

Abstract

M.V. Manukyan

Between January and Julay 2009, 59 patients with symptomatic distal ureteral stones with 5 to 10 mm diameter were enrolled in this study and divided into four groups. Group A (15 patients) received tamsulosin (0.4 mg daily), group B (12 patients) received methipred(20 mg daily), group C (18 patients) received both (0.4 mg tamsulosin + 20 mg methipred daily), and control group D (14 patients) received only analgesics. The treatment duration was 10 days to prevent the side-effects of prolonged corticosteroid therapy. The endpoints were the expulsion rate, analgesic consumption. The rates of expulsion for four groups were 60, 33.3, 83.3, and 28.6%, respectively. There was a significant difference between group C and the other groups (p < 0.001). The mean analgesic consumption was 42 ± 0.7 mg for group A, 50 ± 0.3 mg for group B, 27.4 ± 0.5 mg for group C, and 82 ± 0.48 mg for group D, with a significant difference between group C and the other groups (p < 0.001). During the treatment period, only օne case of drug side-effect related to tamsulosin was recorded. Conclusion: Wen the medical expulsive therapy for symptomatic distal ureteral stones is considered, the use of steroids (methipred) proves efficient only when administered together with α1-blockers (tamsulosin). In addition, tamsulosin, used on its own as a medical expulsive therapy, can be considered as an alternative treatment for those patients, who are not suitable for steroid therapy, as it is generally efficient.

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