An Outpatient Medical Expulsive Therapy for Unilateral Single Ureteric Calculi with SOADS Regime: Our 9 Years Experience with 3000 Patients

Abstract

Introduction : The most important recent advances in the managememt of ureteral calculi have been the development of medical expulsive therapy to facilitate passage of ureteral stones. Drugs like alpha 1 adrenergic blockers with or without corticosteroids along with hydration have been used to facilitate expulsion of stones. Material & Methods : 3000 patients, from January 2008 to December 2017, who were diagnosed to have ureteric calculi either by USG / NCCT and presented to our OPD within first 2 days of colic were enrolled in this study. They were started with SOADS regime which included Tab Alfa blocker ( Alfuzocin 10 mg ) once daily, Tab Drotaverine Hydrochloride 80 mg + Tab Mefenamic Acid 250 mg Twice Daily , Tab spironolactone 25 mgonce daily , Tab ofloxacin 200 mg Twice daily and Syrup Potassium magnesium citrate 2 Tsf with one glass of water three times daily with 2-3 litres of fluid for a period of 2 – 4 weeks . Results : Out of 3000 pt , 2550 pts ( 85 % ) passed the stone with SOADS regime. 65 % of pt passed within 2 weeks of therapy and 20 % within 4 weeks. Stone size of 4mm, 5mm & 6 mm comprised 65 % who passed within 2 weeks and rest 20 % pts had stone size of 7mm, 8mm & 9mm. Rest of the 15 % were managed by URSL. An interesting observation was noticed that pts with obstructive stone unilaterally had increased BP of 10 mmhg both systolic and diasystolic. Conclusion :. It is possible to facilitate explusion of ureteric calculi with SOADS regime in patients who present within first 2 days of colic and thus avoid surgical intervention and thereby reducing the cost and lost working days.