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Are Cepocef And Meftal-Spas Right Medication For Vesicoureteric Junction Calculus?

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Posted on Mon, 4 Jul 2016
Question: hi dr. six days ago i suffered with left lower abdominal pain in afternoon that was only for 5 minutes and again around 8 pm i felt pain in same area. i rushed into emergency. there, i got treated only for pain by giving IV (i dont remember the medication) and i was told to undergo an ultrasound of the abdomen. The same night, i took keterol as per the emergency dr, but felt pain every now and then. The next morning (saturday) i had undergone an ultrasound, which revealed a right sided 7 mm calculus at VUJ with early back pressure. Then, I met with urologist, he said it is better to remove with endoscopy. i asked whether it can be cured with medicines. Doctor said it takes one month to be cured and he gave a 5-day course of cepocef-200 and meftal-spas. I completed the course yesterday and i did not felt any pain till now. I would like to know that with this medicine the stone would be dissolved or to continue with the same med or any other med and to not get such kind of problem again in the future. Please help me with your valuable solution dr... Thanks.
doctor
Answered by Dr. Dr. P. T. Patil (1 hour later)
Brief Answer:
Stone never gets dissolved with any medicine .

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have repeated attacks of ureteric colic due to a stone of a size of 7 mm impacted at Uretero Vesicle Junction (UVJ).

At the outset I would explain you the patho physiology of pain in abdomen due to stone in ureter.

The pain in abdomen is never due to stone itself per se
,
Whenever stone gets impacted at narrow sites in the ureter it obstructs the flow of urine from kidney down into ureter and causes accumulation of urine proximal to the site of obstruction ,This leads to to dilatation of ureter and kidney what is called as Hydronephrosis and this hydronephrosis gives rise to pain (Due to stretching of nerve endings in ureteric wall) .

Moment the stone gets dislodged or moves down the free flow of urine down in to ureter is restored resulting in to relief from pain .

Primary aim in management of stone is to decompress the proximal dilated system and to prevent the kidney damage and save kidney from back pressure changes due to impacted stone and removing the stone is a secondary

There are two option of treatment for ureteric stone
1) Wait and watch (Expectant treatment) and let the nature take its own call and let the stone pass down spontaneously which happens if the stone is small in size up to 8 mm .However it is very difficult to predict how long it will take this process..

2) Second option is to remove or crush the stone by an endoscopic procedure called Uretero Renoscopy(URS) ..

In a given situation I would suggest you to wait and watch for stone to move down by following regime
1) Drink more water to produce more urine .
2) Take tab Tomsulosin and Drotaverine twice daily .These drugs help to dilate the ureter and there by help in moving the stone down .
3) Take antibiotic to prevent infection
4) Repeat Ultrasound Scanning after 2 weeks to see the status of the stone .

In majority of cases this regime works to pass the stone spontaneously.However if the pain is persistent and one gets vomiting and fever suggesting infection one has to undergo endoscopic intervention to remove the stone and make the passage clear off obstruction and to save kidney.

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (24 minutes later)
Thank you Doctor for your valuable answer.. You have mentioned to take tab Tomsulosin and Drotaverine twice daily and take antibiotic to prevent infection. i would like to know for how many days i should take Tomsulosin and Drotaverine and please mention the name of antibiotic also and the duration of course. Is it necessary to take pan-d also? Please reply dr..
doctor
Answered by Dr. Dr. P. T. Patil (2 hours later)
Brief Answer:
Take medications for 10 days .

Detailed Answer:
Hello
Thanks for follow up .Tale Ciprofloxacin twice daily along with Tomsulosin and Drataverine for ten days and repeat your Ultrasound scan .

Thanks and Regards
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (2 days later)
Hello Dr GM.

As per your advise, I am using the above medications, everything thing is fine, no pain till now, but I noticed one different problem. Since I was diagnosed with this stone, we never had sexual intercourse. Today morning, we involved into that act, but at climax, i felt ejaculation, but no sperm. Now this has become a big concern for me, much worried. Is this because of using the medications (side effects)?. Will this problem be set-right? Need to change any meds? Please help me Doctor. I am waiting for your reply.. Thanks..
doctor
Answered by Dr. Dr. P. T. Patil (3 hours later)
Brief Answer:
You have what is called as Retrograde Ejaculation .

Detailed Answer:
Hello
Thanks for follow up .
You have what is called as Retrograde Ejaculation .This is due to known side effect of Tomsulosin and will be there as long as you are taking Tomsulosin It will get resolved on the day you stop taking Tomsulosin .

Thanks and Regards.
Dr,Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (21 minutes later)
Thanks Dr... So, shall I continue taking all the meds dr... Today morning, i did not take any of the med because i was waiting for your reply, thinking of that any change in meds... and Dr.. i have one doubt, does 7 mm stone can be passed through urination? I will be waiting for your valuable answer/advise.. Thanks
doctor
Answered by Dr. Dr. P. T. Patil (5 minutes later)
Brief Answer:
Conntinue taking medicines .

Detailed Answer:
Hello
Thanks for follow up .
Continue taking medicines .A stone of a size of 8 mm pass out easily through urethra .
Thanks and Regards.
Dr.Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. P. T. Patil

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Are Cepocef And Meftal-Spas Right Medication For Vesicoureteric Junction Calculus?

Brief Answer: Stone never gets dissolved with any medicine . Detailed Answer: Hello Thanks for your query ,based on the facts that you have posted it appears that you have repeated attacks of ureteric colic due to a stone of a size of 7 mm impacted at Uretero Vesicle Junction (UVJ). At the outset I would explain you the patho physiology of pain in abdomen due to stone in ureter. The pain in abdomen is never due to stone itself per se , Whenever stone gets impacted at narrow sites in the ureter it obstructs the flow of urine from kidney down into ureter and causes accumulation of urine proximal to the site of obstruction ,This leads to to dilatation of ureter and kidney what is called as Hydronephrosis and this hydronephrosis gives rise to pain (Due to stretching of nerve endings in ureteric wall) . Moment the stone gets dislodged or moves down the free flow of urine down in to ureter is restored resulting in to relief from pain . Primary aim in management of stone is to decompress the proximal dilated system and to prevent the kidney damage and save kidney from back pressure changes due to impacted stone and removing the stone is a secondary There are two option of treatment for ureteric stone 1) Wait and watch (Expectant treatment) and let the nature take its own call and let the stone pass down spontaneously which happens if the stone is small in size up to 8 mm .However it is very difficult to predict how long it will take this process.. 2) Second option is to remove or crush the stone by an endoscopic procedure called Uretero Renoscopy(URS) .. In a given situation I would suggest you to wait and watch for stone to move down by following regime 1) Drink more water to produce more urine . 2) Take tab Tomsulosin and Drotaverine twice daily .These drugs help to dilate the ureter and there by help in moving the stone down . 3) Take antibiotic to prevent infection 4) Repeat Ultrasound Scanning after 2 weeks to see the status of the stone . In majority of cases this regime works to pass the stone spontaneously.However if the pain is persistent and one gets vomiting and fever suggesting infection one has to undergo endoscopic intervention to remove the stone and make the passage clear off obstruction and to save kidney. Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you . Thanks and Regards. Dr.Patil.