Corticosteroids and Tamsulosin in the Medical Expulsive Therapy for Symptomatic Distal Ureter Stones: Single Drug or Association?

To assess the clinical role of corticosteroids in the medical expulsive therapy of symptomatic distal ureteral stones. Between January 2004 and September 2005, 114 patients with symptomatic distal ureteral stones with a ≥5mm diameter were enrolled in this prospective study and divided into four groups based on the urologist (of four) who treated them in the emergency unit. Group A (33 patients) received tamsulosin (0.4mg daily), group B (24 patients) received deflazacort (30mg daily), group C (33 patients) received both (0.4mg tamsulosin+30mg deflazacort daily), and control group D (24 patients) received only analgesics. The treatment duration was 10 d to prevent the side-effects of prolonged corticosteroid therapy. The end points were the expulsion rate, analgesic consumption, number of ureteroscopies, and safety. The groups were comparable in terms of age, sex, and stone location. The stone diameter was 5.96±0.33mm for group A, 5.83±0.4mm for group B, 5.88±0.23mm for group C, and 5.71±0.5mm (p>0.05) for group D. The rates of expulsion for the four groups were 60%, 37.5%, 84.8%, and 33.3%, respectively. There was a significant difference between group C and the other groups (p