Comparison of the therapeutic effects of diclofenac sodium, prednisolone and an alpha blocker for the treatment of renal colic

Objective: In this study, we compare the efficacy of diclofenac sodium, methylprednisolone and alpha-blockers for the treatment of renal colic treatment.

Material and methods: A total of 30 patients between the ages of 18-70 were included in this study. Patients were referred to the Meram Medical Faculty Urology Department or Department of Emergency Medicine at Selcuk University between October 2008 and January 2009. This prospective study was approved by the Selcuk University Meram Medical Faculty Ethics Committee. Patients were randomly divided into 3 cohorts of 10 patients each. The first group consisted of patients receiving diclofenac sodium and an alpha blocker, the second group of patients received diclofenac sodium and prednisolone, and the third group of patients received diclofenac sodium alone. Each patient was diagnosed and evaluated by the same clinician. Evaluation was based on the Numerical Classification Score (NCS) and the Renal Colic Symptom Score (RCSS). Pain intensity was evaluated prior to medication administration and 5, 10, 15, 20, and 30 hours thereafter. Statistical analysis was performed using chi-squared analysis and the Kruskal-Wallis test. P-value of ≤0.05 were considered statistically significant.

Results: Symptoms immediatiely prior to medication administration and after 5, 10, 15, 20 and 30 hours are evaluated. There are no significant differences between the groups (p>0.05). In group 1, stone expulsion occured in 4 patients (40%), a finding that is statistically significant (p=0.01). No adverse events occurred in any group during this study.

Conclusion: Comparison of the therapeutic response among the 3 groups revealed no statistically significant difference. The most important aspects to consider in regard to a treatment modality include diminishing pain, dissolving blockage, a preservation of renal function and minimizing the side effects.