Effect of medical expulsive therapy on the health-related quality of life of patients with ureteral stones: a critical evaluation

Abstract

Purpose: To evaluate the possible effects of medical expulsive therapy (MET) on the health-related quality of life (HRQOL) of the patients under watchful waiting for ureteral stones.

Patients and methods: A total 120 patients with ureteral stones were included into this study program. Patients were divided into two subgroups. While patients in group 1 received medical therapy only for colic pain if needed, patients in group 2 received MET (tamsulosin 0.4 mg/once daily) in addition to medical therapy. All cases were evaluated weekly during 1-month period, and the patients with persistent stones after this period in both groups were evaluated with respect to the analgesic requirement, number of renal colic attacks as well as emergency department (ED) visits along with the QOL scores.

Results: Mean values of patient age and stone burden were 37.14 ± 2.46 years and 42.04 ± 2.03 mm(2), respectively. Evaluation of the cases with residing stones after 4 weeks (28 cases in group 1 and 27 cases in group 2) with or without MET revealed following findings; renal colic, total amount of analgesic required and the mean number of ED visits were significantly lower in cases receiving MET. Evaluation of the mean HRQOL in terms of EQ-5D index and EQ-5D VAS values in both groups again demonstrated higher mean values in patients undergoing MET (p < 0.05).

Conclusion: Our findings indicated that MET for ureteral calculi during watchful waiting period could increase the HRQOL scores by lowering the number of both renal colic attacks and ED visits resulting in decreased analgesic need.