To compare the safety and efficacy of naftopidil and tamsulosin as medical expulsive therapy in combination with deflazacort for distal ureteral stones

Purpose: To compare the safety and efficacy of naftopidil and tamsulosin with deflazacort as medical expulsive therapy for distal ureteric stones. Methods: This prospective study comprised of 60 patients with distal ureteric stones measuring less than or equal to 10mmThe patients were divided randomly into two groups. Thirty patients in group A received tamsulosin (0.4 mg/daily) orally and deflazacort (6mg/daily) and thirty patients in group B received naftopidil (75mg/daily) orally and deflazacort (6mg/daily) and were observed for two weeks for expulsion rate, expulsion time and analgesic dose required. Results: In our study we found that the stone expulsion rate was 76.6% in group A and 83.3% in group B. The expulsion rate in the first week was 60% and that in the second week was 40% and in group A, the expulsion rate was 100% in the first week(table 2) in group B which was statistically significant (p<0.001). The use of analgesic and the number of episodes of pain was also significantly lower in groups B than in group A (p<0.001) Conclusion: It is found that medical expulsive therapy using either naftopidil or tamsulosin along with deflazacort is safe and effective compared with watchful waiting for distal ureteral stones. There was a trend toward a better expulsion rate of ureteral stones in the group treated with naftopidil, but this needs to be studied further in adequately powered studies.