title: Outcome of α-blockers, with or without methylprednisolone combination, in medical expulsive therapy for lower ureteric stones: A prospective randomised study.
abstract: OBJECTIVE
  To compare the safety and efficacy of tamsulosin, alfuzosin, and their combinations with methylprednisolone, in the medical management of lower ureteric stones.
  
  
  METHODS
  Between September 2012 and June 2014, patients diagnosed with a single lower ureteric stone of ⩽10 mm (longest dimension) were enrolled. Patients with urinary tract infection, severe hydronephrosis, pregnancy, hypertension, diabetes, ulcer disease, or renal insufficiency were excluded. According to the medication added to the analgesic anti-inflammatory, patients were stratified into four groups, with 53 patients in each. Group I patients received tamsulosin 0.4 mg and those in Group II received tamsulosin 0.4 mg and methylprednisolone 8 mg. Group III patients received alfuzosin 10 mg and those in Group IV received alfuzosin 10 mg and methylprednisolone 8 mg. Treatment was continued until stone expulsion or to a maximum of 2 weeks. The patients' demographics, stone criteria, and stone-free rates were calculated and analysed.
  
  
  RESULTS
  The mean (SD) maximum stone dimension was 7.8 (1.5), 8.1 (1.3), 7.9 (1.6) and 8.0 (1.4) mm in Groups I, II, III and IV, respectively. Groups II and IV had significantly higher stone-free rates than Groups I and III (P < 0.05), whilst there were no statistically significant differences between Groups I and III or between Groups II and IV. There was no statistical difference among the four groups for the time to stone expulsion. Three patients in Group II and two patients in Group IV developed transient hyperglycaemia, which resolved after cessation of methylprednisolone.
  
  
  CONCLUSIONS
  The combination of alfuzosin or tamsulosin with methylprednisolone seems to be effective and safe for managing lower ureteric stones of <1 cm.
authors.affiliation: Zagazig University, Faculty of Medicine, Urology Department, Zagazig, Sharkia, Egypt.
authors.forename: Waleed
authors.initials: W
authors.lastname: Shabana
authors.affiliation: Zagazig University, Faculty of Medicine, Urology Department, Zagazig, Sharkia, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Teleb
authors.affiliation: Zagazig University, Faculty of Medicine, Urology Department, Zagazig, Sharkia, Egypt.
authors.forename: Tamer
authors.initials: T
authors.lastname: Dawod
authors.affiliation: Saad Specialist Hospital, Urology Department, Alkhobar, Saudi Arabia.
authors.forename: Hisham
authors.initials: H
authors.lastname: Abu Taha
authors.affiliation: Zagazig University, Faculty of Medicine, Urology Department, Zagazig, Sharkia, Egypt.
authors.forename: Alla
authors.initials: A
authors.lastname: Abdulla
authors.affiliation: Zagazig University, Faculty of Medicine, Urology Department, Zagazig, Sharkia, Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Shahin
authors.affiliation: Zagazig University, Faculty of Medicine, Urology Department, Zagazig, Sharkia, Egypt.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Eladl
authors.affiliation: Zagazig University, Faculty of Medicine, Urology Department, Zagazig, Sharkia, Egypt.
authors.forename: Safwat
authors.initials: S
authors.lastname: Abo-Hashem
keywords: KUB, plain abdominal radiograph of the kidneys, ureters and bladder; MET, medical expulsive therapy; Methylprednisolone; SWL, shockwave lithotripsy; URS, ureteroscopy; Ureteric stones; Urolithiasis; α-Blockers