[Methylprednisolon acetate in the management of distal ureteral stones]

ABSTRACT

Acute renal colic is a common complaint from patients entering the emergency departments. Although, urethral lithotripsy and extracorporeal shock wave lithotripsy are known to be effective, the role of medical-expulsive therapy for the treatment of this disease has not yet been established. This study assessed the clinical efficacy of addition methylprednisolon acetate in the medical-expulsive therapy of distal ureterolithiasis. Eighty five [85] consecutive patients with a symptomatic distal urethral stone were included in our study and randomized to one of two home treatment groups. Group A patients [n = 45] received tramadol [50mg bid] and hydrochlorothiazide [50 mg daily] for 21 days, and group B patients [n = 40] were treated with a corticosteroid drug [methylprednisolon acetate 40mg intra-muscular on 0, 7 and 14 days after treatment], in addition to tramadol and hydrochlorothiazide. The treatment duration was 21 days. All patients were re-evaluated after 21days with a clinical examination and KUB. The mean stone size was 5.2mm and 5.8mm in groups A and B respectively [P value>0.05]. Both groups had a significant difference in expulsion rate [20[44.4%] for group A and 32 [88%] for group B; [P value<0.001]. Our results suggest that the use of a corticosteroid drug in association with tramadol and hydro-cholorothiazid appeared to induce an increase in the expulsion rate