A randomized controlled study of nifedipine and alfuzosin in the management of distal ureteric stones

Introduction: Stone disease is a world wide health problem. We evaluated the efficacy of nifedipine and alfuzosin in the medical management of symptomatic, uncomplicated lower ureteral stones. Materials & methods: This was a randomized controlled prospective study to determine the efficacy of alfuzosin and nidedipine as medical expulsive therapy, to increase the stone-expulsion rates in distal ureteric calculus of size less than 10 mm. Patients were randomly divided into three equal groups of 70 patients each. Patients in group I received nifedipine 30 mg/day, group II received alfuzosin 10 mg/day and group III received a placebo in same dose frequency. Patients were followed up weekly until the patient was stone free or upto 28 days. Statistical analysis was performed and P<0.05 was considered to be significant. Results: Stone expulsion was observed in 60%, 85.7%, and 20% patients in group I,II,III respectively. A statistically significant difference was noted in between groups I vs III, groups II vs III and groups I and II (P<0001, P<0.0001 and P<0.0315 respectively). The mean pain attack episodes were 5.91+-1.01 for group I, 3.8+- 0.83 for group II, and 5.82+-1.12 for group III, which is statistically significant in group II versus III, and groups I versus II(P<0.001 and P<0.001). Conclusions: The use of alfuzosin and nifedipine as a medical expulsive therapy for distal ureteric stones is safe and effective in term of increased stone expulsion rate, reduced pain attacks and decreased hospital re-admissions.