Sohail Yousif Arain, Syed Asad Ali, Muhammad Mairaj, Akmal Jamal Siddiqui
There has been a paradigm shift in the management o f ureteral calculi in the last decade with the introduction of new less invasive methods, such as ureterorenoscopy and extracorporeal shock wave lithotripsy (ESWL). Recent studies have reported e xcellent results with medical expulsive therapy (MET) for distal ureteral calculi, both in terms of stone expulsion and control of ureteral colic pain . We conducted a comparative study in between watchful w aiting and MET with tamsulosin.We conducted a comparative study in between watchful waiting (Grou p I) and MET with tamsulosin (Group II) in 60 patients, with a follow up of 28 days. Statistical Analysis was done using SPSS Version 17.0. Group II showed a statistically significant advantage in ter ms of the stone expulsion rate. The mean number of episodes of pain, mean days to stone expulsion and mean amount of analgesic dosage used were statistically significantly lower in Group II (P va lue is 0.007, 0.01 and 0.007, respectively) as comp ared to Group I. It is concluded that MET should be cons idered for uncomplicated distal ureteral calculi before ureteroscopy or extracorporeal lithotripsy. Tamsulosin has been found to increase and hasten stone expulsion rates, decrease acute attacks by ac ting as a spasmolytic, reduces mean days to stone expulsion and decreases analgesic dose usage.
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