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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109

Volume 4, Issue 2, 2012 pp 90-93

Research Article

Progesterone Hydrotherapy in Management of Small, Mid and Lower ureteric calculi

Mandar Tilak1, Nikhil Bhamare2

{1Assistant Professor, 2Resident 3rd yr} Dept of Surgery, Dr Shankarrao Chavan Govt Medical College, Nanded (MS) INDIA.

Academic Editor:  Dr. Aher K. R.

Abstract

Aim: To study efficacy of pcrogesterone utilizing its smooth muscle relaxant action for augmenting hydrotherapy for medical management of small  mid and lower ureteric calculi. Materials and methods : Patients of mid and lower ureteric calculi in age group 20 t0 50 were selected. They were evaluated for size of calculus, kidney function tests, serum electrolytes as well as cardio-respiratory fitness assessment  was done. 80 patients with calculi of size 6mm-1.5 mm, with normal kidney functions, normal lipid profile as well as normal cardio-respiratory fitness were selected for the study. These were randomly divided into two groups; labeled control and test group such that each group had 40 pts with ; 20pts with mid and 20 with lower ureteric or vesico-ureteric junction.(VUJ) calculi .After written informed consent, patients in test group were given following therapy: Inj depot medroxy-progesterone acetate 300mg i.m single dose  hydrotherapy : (1pint normal saline + inj Lassix 20 mg ) such 3 times daily for  5 days.In control group Plain Hydrotherapy as mentioned above was given.Patients were observed for 7 days in hospital and for 2 weeks on O.P.D basis after discharge and results were tabulated. Results: The expulsion rate was significantly higher in group-2 i.e test group where progesterone was used for calculus expulsion (65 & 80 % for mid & lower urtereic calculi) as compared to control group of plain hydrotherapy (30 & 45 % respectively). Average time of extrusion of the calculi for test group was 4 days while for the control group was 10 days.Extrusion with progesterone therapy occurred more for lower ureteric calculi and V.U.J calculi and more so in females as compared to males. Average size of urtereric calculus expelled by progesterone therapy was 9.5mm with largest size being 1.4cm.Conclusion : Progesterone due to its smooth muscle relaxant action can be effectively used in medical management of small mid, lower and vesico-ureteric junction calculi up to 1.4mm size. This is an economical and can be practiced at peripheral centers.