We prospectively evaluated the efficacy of administering tamsulosin with or without deflazacort, combined with furosemide, for treating distal ureteral stones.

A total of 241 patients with symptomatic distal ureteral stones were enrolled in this study between January 2004 and September 2007. They were divided into three treatment groups: group A (n=42) who received furosemide (40mg/day), group B (n=66) who received furosemide and tamsulosin (0.4mg/day) and group C (n=72) who received furosemide and tamsulosin plus deflazacort (24mg/day) for a maximum of 2 weeks. Follow-up visits were made at the 1st and the 2nd week after all the medication had been administered. The efficacy was evaluated in terms of the success rate and the time for achieving expulsion after administering the medication, according to the stone size.

The three groups were comparable in terms of age, gender and stone size. The stone diameter was 4.90±0.47mm for group A, 5.08±0.30mm for group B and 5.04±0.36mm for group C. The overall success rate was 64.3%, 80.3% and 91.7%, respectively, and the differences were statistically significant (p=0.001). The mean expulsion time for the smaller stones (<5mm) was 9.13 days, 6.25 days and 5.43 days for each group, respectively, while that for the larger stones (≥5mm) was 10.25 days, 8.93 days and 7.32 days, respectively, and the values for both sized stones showed statistically significant differences (p=0.027 for the smaller stones, 0.018 for the larger stones). There was no serious adverse event associated with the medication.

Medical expulsive therapy with tamsulosin and deflazacort combined with furosemide is a time saving, safe and effective method for treating distal ureter stone.