We evaluated the efficacy of tamsulosin and nifedipine in medical expulsive therapy (MET) in patients with distal ureteral stone. In addition, we tried to determine the predictive value of Hounsfield Unit (HU) of the stone in the success of MET. A total of 75 patients with a distal ureteral stone of 5–10 mm diameter were randomly divided into three groups. Group 1 (n = 25) received tamsulosin 0.4 mg/d; group 2 (n = 25) received nifedipine 10 mg/day p.o and group 3 (n = 25) received diclofenac sodium 50 mg p.o. when required. At the beginning of each treatment, the HU of the stone was also measured using a non-contrast computerized tomography in all the patients. The results were evaluated at week four. The mean age of the patients was 36.8 (range, 16–68) years. Stone expulsion was observed in 19 (76%) patients in group 1, 16 (64%) patients in group 2 and 9 (36%) patients in group 3 (p_group1-3 = 0.004, p_group2-3 = 0.048 and p_group1-2 = 0.355). The mean expulsion time was 9, 9.1 and 10.3 d, respectively (p_group1-3 < 0.001, p_group2-3 < 0.001 and p_group1-2 = 0.619). The mean diclofenac sodium dose per patient was 544, 602 and 1408 mg in groups 1, 2 and 3, respectively (p_group1-3 < 0.001, p_group2-3 < 0.001 and p_group1-2 = 0.977). The mean HU of the stone in patients with and without a successful MET was 363 and 389, respectively (p = 0.462). Our results showed that MET with both nifedipine and tamsulosin provided a similar increase in the expulsion rate for distal ureteral stones. HU does not seem to be a predictive parameter for stone expulsion.

Since from its clinical introduction to the present time, measurement of serum Prostate Specific Antigen (PSA) level is one of the most widely used tests in urology practice. Initially, the upper limit for PSA was 4 ng/mL, but today, a reduction for the upper limit is recommended to 2.5-3 ng/mL for patients between 60 and 65 years and younger. On the use of PSA as a screening test for prostate cancer, there are differences of opinion. However, it is a recommended test in the evaluation and monitoring of the risky group for prostate cancer. All in all, together with a good patient information, PSA test should be performed at appropriate intervals for appropriate people with an appropriate age.