Medical expulsive therapy for the management of ureteric calculi
Keywords:
Ureteric stone, Dicontin-K, Nifedipine, PrednisoloneAbstract
Ureteric stones in endemic areas if treated on OPD basis with helps of oral drugs saves hospitalization and economic burden to the patient and the hospital. A prospective study was carried out for 9 and half years in two medical colleges by offering two different regimes to patients on random basis and regular follow-up was done on OPD basis. The stone passage rate was highest in the lower ureter 1/3rd (80%) followed by middle 1/3rd (45%) and upper 1/3rd (40%). The patients who were offered regime 1 which included diuretics had less success rate then that with regime 2 which included drugs like nifedipine and steroids. Treatment of ureteric stones on OPD basis in endemic areas is a boon for the patients and for the health management system in terms of cost and health care system.
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References
Segura JW, Preminger GM, Assimos DG, et al. Ureteral stones: clinical guidelines-panel summary report on the management of ureteral calculi. Journal of Urology 1997; 158: 1915-1921.
O'Flynn JD. The Treatment of Ureteric Stones: Report on 1120 Patients. British Journal of Urology 1980: 52: 436-438.
Miller OF, Kane CJ. Time to stone passage for observed ureteral calculi: A guide for patient education. Journal of Urology 1999; 162: 688-91.
Cooper JT, Stack GM, Cooper TP. Intensive medical management of ureteral calculi Journal of Urology Oct 1 2000; 56(4):575-8.
Porpiglia F, Ghignone G, Fiori C, Fontana D, Scarpa RM. Nifedipine versus tamsulosin for the management of lower ureteral stones. Journal of Urology. Aug 2004; 172(2): 568-71.
Bensalah K, Pearle M, Lotan Y. Cost-effectiveness of medical expulsive therapy using alpha-blockers for the treatment of distal ureteral stones. Euro Urology 2008;53:411-8.
Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M.Guidelines on urolithoiasis. Euro Urology 2001; 40:362.
Priminger GM, Tiselius HG, Assimos DG, Alken P, Buck C,Gallucci M, Knoll T, Lingeman JE et al. 2007 Guideline for the Management of Ureteral Calculi. Journal of Urology 2007; 178:2418.
Troxel SA, Jones AW, Magliola L, Benson JS. Physiologic effect of nifedipine and tamsulosin on contractility of distal ureter Journal of Endourology 2006; 20: 565-8.
Shokeir AA, Abdulmaaboud M, Farage Y, Mutabagani H. Resistive index in renal colic: The effect of nonsteroidal anti-inflammatory drugs. British Journal of Urology 1999; 84:249-51.
Bove P, Kaplan D, Dalrymple N, et al. Re examining the value of hematuria testing in patients with acute flank pain. Journal of Urology. Sep 1999; 162:685-7.
Ueno A, Kawamura T, Ogawa A, Takayasu H. Relation of spontaneous passage of ureteral calculi to size. Journal of Urology 1977; 10: 544 -546
Hubner WA, Irby P, Stoller ML. Natural history and current concepts for the treatment of small ureteral calculi. Euro Urology 1993; 24: 172-6.
Singh A, Alter HJ, Littlepage A. A systematic review of medical therapy to facilitate passage of ureteral calculi Annals Emergency Medicine. Nov 2007; 50(5):552-63.
Hollingsworth JM, Rogers MA, Kaufman SR, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet 2006;368:1171-9.
