ABSTRACT
Aim: This study aims to compare the effect of tamsulosin versus placebo in the management of lower ureteric stones.Material and Methods: A total of 100 diagnosed patients of lower ureteric stone from the period of June 1, 2018, to May 31, 2019(12 months), were taken for the study. The study group was divided into three groups, Group A taken tamsulosin 0.4 mg + steroids(deflozacort 6 mg), Group B taken tamsulosin 0.4 mg + dicyclomine 20 mg, and Group C dicyclomine 20 mg alone. The results ofthree group were compared by expulsion rate and expulsion time of stones. Chi-square test was used for calculating the effect.Results: The mean age of Group A was 38.46 ± 10.68 years, Group B was 33.87 ± 9.62 years, and in Group C 32.94 ± 7.07 years.There was no significant relation between ages in stone expulsion. The mean calculus size in Group A was 5.93 ± 2.12 mm, Group Bwas 6.00 ± 2.03 mm, and Group C was 5.00 ± 2.01 mm. P = 0.784 was not statistically significant. In Group A, 40% of stones were onthe left side and 29.7% on the right side, in Group B, 20% of stones were on the left side and 40% on the right side, and in Group C,40% of stones were on the left side and 30.7% on the right side. P = 0.126 is not statistically significant. The mean time taken for stoneexpulsion in Group A was 5.39 ± 1.94 days, Group B was 4.75 ± 2.03 days, and Group C was 6.76 ± 1.90 days. P = 0.006 (<0.05)is highly statistically significant. Hence, in the present study, in Group A, 29 patients out of 33 patients, in Group B, 28 patients outof 33, and in Group C, 22 patients out of 34 patients, the stone was expelled out. P = 0.040 (<0.05) is highly statistically significant.There was no statistically significant difference which was found between the three groups in age, size, and side of stone.Conclusion: The results of this study have shown a potentially important role of tamsulosin for conservative expulsive therapyof distal ureteral stones, broadening pharmacological indications rather than endoscopic treatments for the resolution of thisdisease. Obviously, further studies with larger number of cases are necessary to validate these promising and statisticallysignificant results. The comparison with minimally invasive procedures in terms of cost and efficacy was useful, highlighting apredominant role of first-line pharmacological treatment, which can be easily be provided in an outpatient setting and not onlyat large, technologically advanced, centers. The drug tamsulosin proved to be safe and effective as demonstr ated by the lowincidence of side effects and the increased stone expulsion rate and reduced expulsion time. Moreover, medical expulsivetherapy with tamsulosin considerably decreased the analgesic use, thereby reducing additional need for pain relief and servedas an effective bridge between watch-and-wait management and surgical intervention.
ABSTRACT
Introduction:Urolithiasis is one of the most common clinical conditions in the history of medicine. Treatment methods include conservative, surgical treatment and extracorporeal shock wave lithotripsy (ESWL). Several stone characteristics are known to affect outcome of ESWL such as fragility, Hounsfield unit, size, site, composition etc. No study has been done till now regarding the efficacy and safety of ESWL in eastern Indian patients. Objectives: To assess the efficacy and safety of ESWL in the management of patients with renal and ureteral stones. Methods: 112 outpatients were treated with ESWL. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance. Result & Conclusion: The authors found significant association between the size and number of stones with fragmentation status. The authors found that stones of more than 11mm size are more resistant to ESWL. Authors found statistically significant association between the number of ESWL sessions with fragmentation status. However, more than 3 sessions also did not help much. It was also found that complications were more in partially fragmented group and more adjunctive procedures were required in partially fragmented group. The authors also noticed that the stented or non stented status and total number of shocks were not significantly associated with the fragmentation status of stones.
ABSTRACT
Giant ureteral calculus is a rare disease. It remains one of the few special situations where classical treatment of ureterolithotomy is done. We present a case of a 33-year-old female who presented with left flank pain radiating to groin. Investigations revealed two giant ureteral stones measuring 8 cm and 2cm. She was submitted to open surgery. There were no postoperative complications and the patient was discharged from hospital after 4 days. An IVU done 6 months after intervention showed adequate drainage of contrast in bilateral kidneys. This technical procedure could be performed by means of laparoscopy and be even less aggressive.
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A 24 year old male presented with acute pain in left loin with burning micturition, investigation revealed minimal functioning of left kidney with left hydronephrosis and hydroureter and a giant ureteric calculus. He underwent open ureterolithotomy. A giant ureteric calculus measuring 10.5 cm and weighing 49 gm was retrieved from the left ureter post-operative recovery was eventful and was discharged after 10 days.
ABSTRACT
Ureteric stones are a common cause of obstruction of the urinary tract, usually presenting with characteristic signs and symptoms, such as acute ureteric colic and hematuria. Occasionally, stones may present with non-specific symptoms such as low back pain and remain unidentified, leading to stone growth, chronic ureteric obstruction and complications such as hydronephrosis and renal damage. Here, we report a large ureteric stone in a cadaver with complete obstruction at the left ureterovesical junction, resulting in severe dilatation of the left ureter and renal pelvis.
Subject(s)
Cadaver , Colic , Dilatation , Hematuria , Hydronephrosis , Kidney Pelvis , Kidney , Low Back Pain , Ureter , Urinary TractABSTRACT
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.
ABSTRACT
96 patients with 65 males and 24 femals aged from 19-65 years old with colic symptoms at lumbar- abdomen area. Among them 86 cases were urine calculus, 7 cases other conditions diagnosed by bidimension ultrasound a simple technique for diagnosis of most of simple kidney colics. Ultrasound should be used in acute lumbar- abdomen colic, with low sensitivity, this technique showed be associated with X Ray. Measuring the anterior and posterior pyelic diameters in comparing with the healthy kidney for detecting their contraction and dilatation. In case of proof lacking the combination with X Ray will be necessary to determine the function and morphology of ureteral system.