The Role of Tadalafil in expulsion of Lower Ureteric Stone
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 3
Abstract
Background: The Recent Studies Have Reported Outstanding Results Concerning Medical Expulsive Therapy (MET) For Lower Ureteric Stone In Terms Of Stone Expulsion And Control Of Colic Pain. Therefore We Conducted A Prospective Randomized Controlled Study To Evaluate The Role Of Tadalafil In Comparison Of Placebo In Lower Ureteric Stone Expulsion. Objective: To Evaluate The Role Of Phosphodiesterase 5 Inhibitor (Tadalafil) 10mg In Conservative Therapy For Patients With Lower Ureteral Stones. Patients And Methods: From September 2016 To August 2017, 60 Consecutive Symptomatic Patients With Unilateral Lower Ureteric Stone From The Urology And Nephrology Department In Pgims Rohtak Were Enrolled In This Randomized Prospective Placebo Controlled Study. Patients Were Randomly Divided Into Two Groups, Group 1 (N=30) And Group 2 (N=30). Group 1 Was Given Tadalafil 10mg. Group 2 Was Given Placebo. Tadalafil 10mg Or Placebo Was Administered Once Daily. The Treatment Duration Was Until Stone Expulsion Or 14 Days. During This Period, All Patients Were Evaluated Weekly By USG And Serum Creatinine Level And Were Asked Whether They Experienced Acute Colic Pain, To Score The Intensity Of Pain According To A Visual Analog Scale, Whether The Calculus Passed Spontaneously, The Day And Time Of Stone Expulsion, Number Of Analgesic Use, And Any Drug Side Effects Results: The Mean Stone Size Was 7.41mm For Treatment Group And 7.15mm For Placebo Group (P> 0.05) .The Stone Expulsion Rate Was 90% For Treatment Group And 60% For Placebo Group (P<0.05). Mean Expulsion Time Was 5.4 Days For Treatment Group And 9.54 Days For Placebo Group (P=0.001). Mean VAS Was 2.9 For Treatment Group And 6.9 For Placebo Group (P<0.0001). Mean Number Of Tablet Diclofenac Used Was 1.87 For Treatment Group And 7.11 For Placebo Group (P<0.05). The Univariate Analysis Using Cox Proportional Hazard Model Revealed That Only Therapy And Stone Size Proved To Be Significantly Predictive Factors Of Stone Expulsion (P<0.0001 And 0.001) Respectively, While Gender And Age Did Not Have Any Predictive Value. Although Side-Effects Occurred More In Patients Who Were Given Tadalafil 10mg, No Significant Side-Effect Was Detected So As To Require Exclusion Of A Patient From The Study Conclusion: Medical Expulsive Therapy (MET) For Lower Ureterolithiasis With Tadalafil During Conservative Treatment Period Is Safe And Effective As Demonstrated By The Absence Of Serious Side Effects And Increased Stone Expulsion Rate With Early Time. Also MET With Tadalafil 10mg Affords An Outstanding Control Of Pain For Patients While Waiting For Stone Expulsion.
Authors and Affiliations
Dr Amit Mann, Dr Devendra singh pawar, Dr Vikas verma, Dr Sarita Rawat, Dr Lokendra yadav
Keywords
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- EP ID EP369652
- DOI 10.9790/0853-1703107579.
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