Alpha Adrenergic blockers may help expel Ureteric calculus less than 10 mm

Researchers have found in a new study that Alpha-adrenergic blockers facilitate the expulsion of lower ureteric stones ≤ 10 mm.The present study was published in the journal UroToday International Journal.

Lower ureteric calculi are the most frequently encountered clinical conditions in daily Urological practice. Waitful watching, Extracorporeal shock wave lithotripsy (ESWL), and ureteroscopic lithotripsy (URSL) are some of the various treatment modalities used for the management of lower ureteric calculi.

Researchers have tried various drugs for the expulsion of lower ureteric calculi. . In their study the authors evaluated the efficacy of drugs in the expulsion of a lower ureteric calculus of size ≤ 10 mm. The drugs used are tamsulosin, naftopidil, tamsulosin and deflazacort, and naftopidil and deflazacort.

The study was a prospective, randomized study conducted in the Department of Urology from August 2012 to January 2013. A total of 150 patients participated in the study. They were randomly divided into 5 equal groups, each having 30 participants. They were:

• A (control),

• B (naftopidil),

• C (tamsulosin),

• D (naftopidil and deflazacort), and

• E (tamsulosin and deflazacort).

All the participants were subjected to the following tests:

• Complete hemograms

• blood urea; serum creatinine

• urine routine examination and culture and sensitivity

• X-ray of the kidney, ureter, and bladder (KUB); and/or ultrasonography.

All the participants were followed up to 30 days or upon spontaneous passage of the calculus, whichever was earlier. X-ray KUB and/or ultrasonography were done to confirm the passage of the stone.

From the study the authors found the following:

• The expulsion rate for a calculus ≤ 10 mm was statistically significant in all the groups in comparison to the control group.

• The mean days of expulsion and use of analgesics was also low in all the groups compared to control.

• Amongst all groups, the stone expulsion rate was highest, and episodes of pain and mean days of expulsion were lowest for the D group.

The researchers concluded that alpha-adrenergic blockers facilitate the expulsion of lower ureteric stones ≤ 10 mm and decreases the episodes of colic, which is further improved by the addition of deflazacort. They also added that Naftopidil plus deflazacort gives the best results regarding stone expulsion rates, mean days of expulsion, and episodes of colic. 

To read more about the article, click the following link: http://dx.doi.org/10.3834/uij.1944-5784.2013.10.09