Drug Combo Improves Stone Passage

ORLANDO - Tamsulosin plus prednisone works better than either drug alone in clearing distal ureteral stones, investigators reported at the American Urological Association 2014 annual meeting.

In a prospective, non-randomized study, Maurizio Brausi, MD, of B. Ramazzini Hospital in Carpi, Italy, enrolled 120 patients with renal colic who presented to the emergency departments of 2 urology centers. Doctors diagnosed distal ureteral stones radiologically.

The researchers assigned patients to 1 of 3 groups: group A included 40 patients treated with tamsulosin 0.4 mg per day alone; group B, which included 35 patients treated with prednisone 25 mg per day for 5 days, 10 mg per day for 5 days, and 5 mg per day for 5 days; and group C, which included 45 patients treated with tamsulosin 0.4 mg per day and prednisone (following the same schedule as group B). Groups A, B, and C had a mean stone diameter of 7.3, 4.2, and 7.0 mm, respectively. During the study, 3 patients in group A and 3 in group B were lost to follow-up.

Dr. Brausi's group observed spontaneous passage of stones in 67.5% of group A, 34.2% of group B, and 92.8% of group C. Endourological procedures were required for 33.5% of group A, 65% of group B, and 7.8% of group C.

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