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Nifedipine and Methylprednisolone in Facilitating Ureteral Stone Passage: A Randomized, Double-Blind, Placebo-Controlled Study

1994; Lippincott Williams & Wilkins; Volume: 152; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(17)32511-9

1527-3792

Loris Borghi, Tiziana Meschi, Ferdinando Amato, A Novarini, Alfredo Giannini, Cristina Quarantelli, F Mineo,

Pediatric Urology and Nephrology Studies

No AccessJournal of Urology1 Oct 1994Nifedipine and Methylprednisolone in Facilitating Ureteral Stone Passage: A Randomized, Double-Blind, Placebo-Controlled Study Loris Borghi, Tiziana Meschi, Ferdinando Amato, Almerico Novarini, Alfredo Giannini, Cristina Quarantelli, and Francesco Mineo Loris BorghiLoris Borghi , Tiziana MeschiTiziana Meschi , Ferdinando AmatoFerdinando Amato , Almerico NovariniAlmerico Novarini , Alfredo GianniniAlfredo Giannini , Cristina QuarantelliCristina Quarantelli , and Francesco MineoFrancesco Mineo View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)32511-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Expulsive medical therapy of ureteral stones is not well established. To test the efficacy of a calcium antagonist (nifedipine) associated with a corticosteroid (methylprednisolone) in facilitating ureteral stone passage, we studied 86 patients with a unilateral ureteral radiopaque stone not larger than 15mm. in maximum diameter, confirmed in each case by drop excretory urography. Patients were randomly treated for a maximum of 45 days under double-blind conditions with 16mg. methylprednisolone plus 40mg. nifedipine daily (group 1—13 women and 30 men, mean age 45 ± 14 years, standard deviation) and with 16mg. methylprednisolone plus placebo daily (group 2—18 women and 25 men, mean age 43 ± 14 years). All patients also received 2 l. of low mineral content water daily. The average maximum diameter of the stones was 6.7 ± 3.0mm. in group 1 and 6.8 ± 2.9mm. in group 2 (not significant). Partial ureteral obstruction was present in approximately half of the patients in both groups. Four patients in group 1 and 6 in group 2 dropped out of the study. In group 1, 34 patients had successful results (stone passage without surgical manipulation) and 5 failed (success rate 87%), compared to 24 and 13, respectively, in group 2 (success rate 65%). This difference was significant (p = 0.021, Fisher's exact test). No difference was present in the maximum stone diameter among the successful cases in groups 1 and 2 (6.4 ± 2.8 and 5.3 ± 2.2mm., respectively, not significant). In both groups the maximum diameter of the stone was larger in the failed than in the successful cases (group 1—10.4 ± 3.0 versus 6.4 ± 2.8mm., p = 0.005, and group 2—9.3 ± 2.5 versus 5.3 ± 2.2mm., p = 0.0001). In group 1 the mean interval for stone passage in the successful cases was 11.2 ± 7.5 days, compared to 16.4 ± 11.0 days in group 2 (p = 0.036, Student's t test). We conclude that nifedipine associated with methylprednisolone is effective in facilitating ureteral stone passage. © 1994 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByBrede C, Hollingsworth J, Faerber G, Taylor J and Wolf J (2018) Medical Expulsive Therapy for Ureteral Calculi in the Real World: Targeted Education Increases Use and Improves Patient OutcomeJournal of Urology, VOL. 183, NO. 2, (585-589), Online publication date: 1-Feb-2010.Bhagat S, Chacko N, Kekre N, Gopalakrishnan G, Antonisamy B and Devasia A (2018) Is There a Role for Tamsulosin in Shock Wave Lithotripsy for Renal and Ureteral Calculi?Journal of Urology, VOL. 177, NO. 6, (2185-2188), Online publication date: 1-Jun-2007.Preminger G, Tiselius H, Assimos D, Alken P, Buck C, Gallucci M, Knoll T, Lingeman J, Nakada S, Pearle M, Sarica K, Türk C and Wolf J (2018) 2007 Guideline for the Management of Ureteral CalculiJournal of Urology, VOL. 178, NO. 6, (2418-2434), Online publication date: 1-Dec-2007.PEARLE M, CALHOUN E and CURHAN G (2018) UROLOGIC DISEASES IN AMERICA PROJECT: UROLITHIASISJournal of Urology, VOL. 173, NO. 3, (848-857), Online publication date: 1-Mar-2005.DELLABELLA M, MILANESE G and MUZZONIGRO G (2018) RANDOMIZED TRIAL OF THE EFFICACY OF TAMSULOSIN, NIFEDIPINE AND PHLOROGLUCINOL IN MEDICAL EXPULSIVE THERAPY FOR DISTAL URETERAL CALCULIJournal of Urology, VOL. 174, NO. 1, (167-172), Online publication date: 1-Jul-2005.PORPIGLIA F, GHIGNONE G, FIORI C, FONTANA D and SCARPA R (2018) NIFEDIPINE VERSUS TAMSULOSIN FOR THE MANAGEMENT OF LOWER URETERAL STONESJournal of Urology, VOL. 172, NO. 2, (568-571), Online publication date: 1-Aug-2004.DELLABELLA M, MILANESE G and MUZZONIGRO G (2018) Efficacy of Tamsulosin in the Medical Management of Juxtavesical Ureteral StonesJournal of Urology, VOL. 170, NO. 6, (2202-2205), Online publication date: 1-Dec-2003.Clayman R (2018) UROLITHIASIS, ENDOUROLOGY AND LAPAROSCOPYJournal of Urology, VOL. 167, NO. 2 Part 1, (794-802), Online publication date: 1-Feb-2002. Volume 152Issue 4October 1994Page: 1095-1098 Advertisement Copyright & Permissions© 1994 by The American Urological Association Education and Research, Inc.Keywordsuretermethylprednisoloneurinary calculinifedipineMetricsAuthor Information Loris Borghi More articles by this author Tiziana Meschi More articles by this author Ferdinando Amato More articles by this author Almerico Novarini More articles by this author Alfredo Giannini More articles by this author Cristina Quarantelli More articles by this author Francesco Mineo More articles by this author Expand All Advertisement PDF DownloadLoading ...