Effectiveness of Alpha Blockers + Corticosteroids in Expulsion of Ureteric Stones: a Clinical Observation

Background: Medical Expulsive Therapy (MET) has become an established part of the protocol for treatment of ureteric stones of less than 5 mm size in the lower 1/3rd of the ureter. Drugs like calcium channel blockers and α-1 adrenergic blockers with or without corticosteroid along with hydration have been used to facilitate expulsion of stones. Aims & Objective: In this study effectiveness of α-1 adrenergic blocker Tamsulosin alone and in combination with corticosteroid deflazacort have been compared. Materials and Methods: Total of 70 symptomatic patients of lower ureteric stones, who presented in the OPD of Rohilkhand Medical College Hospital between Jan 2011 – May 2013, were selected for the study. Patients were randomly divided in two groups: Group 1 (Tamsulosin Group) & Group 2 (Tamsulosin + deflazacort Group). Results: It was found that with Tamsulosin + deflazacort better stone clearance rate with in shorter period was achieved. There was minimum discomfort to the patients during stone expulsion. Success rate was comparable in both groups up to 10 mm stone size. There was marked difference in stones bigger than 10 mm (25% and 62.66% in 11-12 mm size, 16.66% and 57.14% in 13-15 mm size and 0.0% and 50% in 16-17 mm size). Conclusion: MET using Tamsulosin has definite role in passage of smaller size ureteric stone of less than 10mm size. It has acceptable success rate in bigger size stone in our study up to 17 mm size, when Tamsulosin was combined with Deflazacort.