title: Effectiveness of nifedipine and deflazacort in the management of distal ureter stones.
abstract: OBJECTIVE
  To evaluate the effectiveness of medical therapy during watchful waiting in patients with distal ureter stones.
  
  
  METHODS
  Ninety-six patients with radiopaque stones located in the distal tract of the ureter and with stone sizes of 1 cm or smaller were involved in the study. The patients were randomly divided into two groups. Group A (n = 48) received oral treatment with 30 mg of deflazacort daily (maximum 10 days) plus 30 mg of slow-release nifedipine daily (maximum 4 weeks). Group B (n = 48) underwent a wait-and-watch approach. Both groups of patients were allowed to use diclofenac on demand. Statistical analyses were carried out using Student's t test, the chi-square test, and Fisher's exact test.
  
  
  RESULTS
  The average stone size was 5.8 +/- 1.8 mm for group A and 5. 5 +/- 1.4 mm for group B. No statistically significant difference was found in stone size. Stone expulsion was observed in 38 (79%) of 48 patients in group A and in 17 (35%) of 48 patients in group B. The average expulsion time was 7 days (range 2 to 10) for group A and 20 days (range 10 to 28) for group B. A statistically significant difference was observed in both the expulsion rate and the expulsion time (P <0.05). The mean amount of sodium diclofenac used was 15 mg per patient for group A and 105 mg per patient for group B (P <0.05).
  
  
  CONCLUSIONS
  The medical treatment proved to be effective and safe, as demonstrated by the increased stone expulsion rate, decreased expulsion time, and reduced need for analgesic therapy.
authors.affiliation: Divisione Universitaria di Urologia, Dipartimento di Scienze Cliniche e Biologiche, Azienda Ospedaliera S. Luigi, Orbassano, Turin, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Porpiglia
authors.forename: P
authors.initials: P
authors.lastname: Destefanis
authors.forename: C
authors.initials: C
authors.lastname: Fiori
authors.forename: D
authors.initials: D
authors.lastname: Fontana
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000009:adverse effects / Q000627:therapeutic use*; D011282:Pregnenediones / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D014514:Ureteral Calculi / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents; D002121:Calcium Channel Blockers; D011282:Pregnenediones; D009543:Nifedipine; C021988:deflazacort