Effects of minimally invasive surgery combined with methylprednisolone and tamsulosin on the prognosis of calcium-containing ureteral calculi and the levels of urinary monocyte chemotactic protein-1, trefoil factor 1, and high-mobility group box protein 1

Wei Lu^*, Jia-Qiang Wang, Yu-Hong Zhang, Yong Wang

Department of Urology, Jilin Province People’s Hospital, Changchun 130021, China

Introduction: Although extracorporeal shock wave lithotripsy (ESWL) is the preferred treatment for ureteral calculi, the subsequent non-discharge of stones leads to poor prognosis. This study aimed to investigate the clinical outcome of ESWL combined with tamsulosin and/or methylprednisolone.

Materials and methods: From June 2013 to June 2016, 180 patients with calcium-containing ureteral calculi were treated with ESWL and equally randomized into three groups: group A, control patients; group B, patients treated with tamsulosin; and group C, patients treated with tamsulosin and methylprednisolone. The endpoints were stone excretion and adverse reactions. Further, the levels of urinary calcium, monocyte chemotactic protein-1 (MCP-1), trefoil factor 1 (TFF1), and high-mobility group box protein 1 (HMGB1) were determined before and after treatment.

Results: The stone excretion rate was higher in groups B and C than in group A. The stone discharge time, renal colic frequency, analgesic use frequency, stone street formation rate, and repetitive treatment rate were lower in group C than in group B, and lower in groups B and C than in group A (P<0.05). No drug-related toxicities were recorded. Urinary calcium and HMGB1 levels were lower after treatment, whereas the TFF1 level showed a higher increase in group A than in groups B and C. The changes in group C were more significant than those in group B (P<0.05). There was no significant difference in pre-and postoperative MCP-1 levels among the three groups.

Conclusions: The combination of methylprednisolone and tamsulosin along with ESWL in the treatment of calcium-containing ureteral calculi has a high efficacy and can improve the level of urinary inflammatory factors with a good safety outcome.