Dibin Mohammed Bedardeen1, Abhijith Shetty2, Moosabba3
BACKGROUND
Urinary calculus disease is one of the 3 most common urological diseases. It affects about 12% of the world population. Of all the urinary tract stones 20% are ureteral stones of which 70% are found in the lower third of ureter. Patients with ureteric calculi have wide range of complications which include acute pain necessitating hospitalization, urinary tract infection, anuria, acute renal failure, chronic renal failure, hydronephrosis, pyelonephritis and dehydration. The objective of the study is to study the effect of alpha adrenergic blockers in the passage of calculi in the lower third of the ureter compared to NSAIDs and oral fluids.
MATERIALS AND METHODS
The study included a total of 60 patients between the study period from Aug 2014 to Aug 2015. 30 patients were chosen randomly and advised to take plenty of oral fluids and treated with NSAID (diclofenac). The patients were then observed weekly and asked for any history of passage of calculi and ultrasound scan was repeated after 15 days to look for any passage of calculi. The findings were recorded and the patients are monitored and followed up for a period of one month. If the stone was passed successfully, it was confirmed with ultrasonography. After 1 month if treatment failed, conservative management was discontinued and advised surgery.
RESULTS
Majority of the patients were in the age group 20-40 yrs. The mean size of the calculi was 6.62 cms on the right side and 6.0 cms on left side. Out of the 30 patients who were on alpha 1 blocker 22 patients had passed calculi and 8 patients had no results with 73 % success rate. In 30 patients who were not on alpha adrenergic blockers 7 passed out the calculi and 23 did not pass the calculi. 5 among the 23 underwent urethrorenoscopy (URS).
CONCLUSION
Alpha adrenergic blockers is an effective and safe drug in the management of calculi in the lower third of the ureter. Most patients with ureteric calculi were rendered stone free with endourological procedures if conservative treatment failed.
