Medical expulsive therapy for the management of ureteric calculi

Yogendra D. Shah, Pukur I. Thekdi, K. G. Patel


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.


Ureteric stone, Dicontin-K, Nifedipine, Prednisolone

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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.