Efficacy of terazosin as a facilitator agent for expulsion of the lower ureteral stones

OBJECTIVE: To determine the efficacy of terazosin as a facilitator agent for the passage of lower ureteral stones.

METHODS: Since February 2004 to December 2004, 64 patients with lower ureteral stones who came to the emergency department were enrolled in this study. Exclusion criteria were the presence of urinary tract infection, severe hydronephrosis, elevated serum creatinine, hypertension, history of peptic ulcer disease and history of spontaneous stone passage. Patients were randomized into 2 groups of 32. Group 1 patients received terazosin tablets, 10 mg daily and analgesic (indomethacin capsules) for a maximum of 4 weeks, but patients in Group 2 received only analgesic. In cases of incomplete pain control, intravenous pethidine was administered. The 2 groups were compared with regard to stone passage rate, time to stone passage, the amount of received pethidine and the need for intervention. Statistical analysis was performed by student t-test.

RESULTS: The mean age of Group 1 was 44 years and Group 2 was 39 years. The median stone size was 6.9 ± 2.3 mm in Group 1 and 6.6 ± 3.1 mm in Group 2, which was not significantly different. Stone expulsion rate was 90.62% in Group 1 and 62.5% in Group 2, with a significant statistical difference (p=0.041). The mean expulsion time was 76.3 ± 60 hours and 141 ± 64 hours in Groups 1 and 2, (p=0.001). Extra analgesic (pethidine) requirement averaged 34.4 ± 12.7 mg and 62.1 ± 10.5 mg in Groups 1 and 2 (p=0.036). Seven patients in Group 1 and 15 patients in Group 2 required ureteroscopy after 4 weeks due to lack of the stone passage.

CONCLUSION: Terazosin is a safe and effective treatment for lower ureteral stones. By using this medication, stone passage rate increases and the time of stone passage and the need for intervention decreases.