COMPARISON OF THE EFFICACY OF COMBINED THERAPY WITH ORAL TAMSULOSIN PLUS ORAL DICLOFENAC AND TAMSULOSIN ALONE IN TIME AND RATE OF EXPULSION OF DISTAL URETERIC STONES
Keywords:Urolithiasis, medical expulsive therapy (MET), tamsulosin, diclofenac Sodium.
Active Medical Expulsive Therapy (MET) is an aggressive outpatient approach that reduces pain, increases stone passage, and lowers surgery requirements in nephrolithiasis. MET employs alpha-1 selective blockers like Tamsulosin to relax the ureter and NSAIDs as the first-line pain management therapy. Surgical intervention is reserved for cases where medical treatment is ineffective or unlikely to cure the disease.
To compare the effectiveness of combined therapy with Tamsulosin and Diclofenac sodium and Tamsulosin alone in the rate and time of expulsion of distal ureteric stones of size ranging from 5-<9mm.
All male and female patients presenting to urology OPD of Benazir Bhutto Hospital Rawalpindi and Institute of kidney Diseases-Hayatabad medical complex. Peshawar, diagnosed to be having unilateral distal ureteric stone on X-ray KUB were recruited by systematic random sampling and divided into two groups A (study group) and B (control group). Group A was given, Tab.Tamsulosin 0.4mg OD and Tab.Diclofenac sodium 75mg BD for 21 days. Group B was given Tab Tamsulosin 0.4 mg OD for 21 days and acetaminophen 500mg SOS.
The clinical trial revealed that in the group of patients receiving Tamsulosin and diclofenac, the rate of expulsion of distal ureteric stones was improved with a statistically significant difference. Time of expulsion of stones in two groups was not statistically different.
Tamsulosin and Diclofenac sodium given together have added effect as compared to Tamsulosin alone in the rate and time of expulsion of distal ureteric stones
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