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The role of corticosteroids along with alpha blocker in the expulsion of distal ureteric stones as compared to the alpha blocker alone

. Yasir Murtaza, Nadia Shahid, Khurram Baqai, Faiza Quraishi, Jabbar Ahmed Qureshi and Ali Nawaz Bijarani


Abstract

Alpha blockers have shown to increase the rates of expulsion for distal ureteric stones while corticosteroids in combination further help alpha blockers to decrease the stone expulsion time by decreasing the signs of inflammation at the site where the calculus is trapped. The main aim of this study is to compare the frequency of distal ureteral stone expulsion rate in patients given combination therapy (alpha-1 blocker and corticosteroid) as compared to monotherapy (alpha-1 blocker alone). About 108 consecutive cases of lower ureteric stones measuring between 5-10mm were selected with pre-defined inclusion and exclusion criteria. We divided the patients into two groups (A and B) with each group having 54 patients. Group A was given combination therapy with alpha blocker (tamsulosin) and corticosteroid (prednisolone) while group B was given alpha blocker (tamsulosin) alone for about 2 weeks to check the rate of expulsion of distal ureteric stones. Data was analyzed by statistical package of social sciences (SPSS) version-20. The average age of the patients was 45.31 +_9.33 years. The overall rate of stone expulsion at 14 days was 71.3(77/108) and was markedly higher in group A as compared to group B (81.5% vs 61.1%; p=0.019). age stratification analysis showed the rate of stone expulsion at 14 days was significantly higher in group A as compared to group B (85.7% vs. 46.2%; p=0.046) in 51 to 60 years of age. With respect to the size of the stone, the rate of stone expulsion at 14 days was markedly higher in group A as compared to group B (84.8% vs. 58.6%; p=0.021) for those cases who had 6-7 mm size of stone while there was no significant difference seen in the groups who had stone size >7mm. It is concluded that tamsulosin along with prednisolone has a significant impact on distal ureteric stone expulsion rate as compared to tamsulosin alone.

 

Index Terms- Ureteral stones, Alpha blockers, Corticosteroids

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