Role of adjunctive medical therapy with nifedipine and deflazacort after extracorporeal shock wave lithotripsy of ureteral stones.
OBJECTIVE
To increase the success rate of the first treatment of ureteral stones through extracorporeal shock wave lithotripsy (ESWL), we tested the efficacy of a medical therapy with nifedipine and deflazacort administered to patients who had undergone ESWL for ureteral stones.


METHODS
This prospective study lasted from October 1998 to September 2000 and involved 80 patients. All the patients underwent ESWL with Sonolith 4000+. The patients were randomly divided into two groups: 40 patients (group 1) received an "adjunctive" treatment with oral medical therapy (nifedipine and deflazacort); the other 40 patients (group 2) were used as the control group.


RESULTS
Complete fragment expulsion occurred in 30 (75%) of the 40 patients of group 1 and in 20 (50%) of the 40 patients of group 2 at the endpoint. A statistically significant difference was observed in the stone-free rate (P = 0.02). Concerning the symptomatic therapy, the average diclofenac use was 37.5 mg per patient in group 1 and 86.25 mg per patient in group 2 (P = 0.02).


CONCLUSIONS
The results of this study have shown the role that adjunctive medical therapy with nifedipine and deflazacort given after an ESWL procedure can play in increasing the success rate of ureteral stone treatment. Furthermore, these results would suggest that adjunctive medical therapy can reduce total analgesic consumption after the ESWL procedure.
Porpiglia
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Divisione Universitaria di Urologia, Dipartimento di Scienze Cliniche e Biologiche, Azienda Ospedaliera S. Luigi, Orbassano, Torino, Italy.
Destefanis
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P
Fiori
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Scarpa
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RM
Fontana
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D
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D011282:Pregnenediones / Q000627:therapeutic use*; D011446:Prospective Studies; D014514:Ureteral Calculi / Q000188:drug therapy / Q000628:therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011282:Pregnenediones; D004008:Diclofenac; D009543:Nifedipine; C021988:deflazacort