Efficacy of Adjunct Corticosteroid Therapy in the Management of Pediatric Renal Colic: A Quasi-Experimental Study on Pain Reduction and Stone Expulsion
DOI:
https://doi.org/10.52206/jsmc.2026.16.2.1232Abstract
Background: Renal colic is a frequent and highly painful urological emergency in children, primarily caused by ureteric obstruction due to urinary calculi. Although non-steroidal anti-inflammatory drugs (NSAIDs) remain the cornerstone of management, their potential adverse effects highlight the need for safer and more effective adjunct therapies. Corticosteroids, due to their anti-inflammatory properties, may offer additional benefits in reducing pain and facilitating stone passage.
Objective: This study aimed to evaluate the efficacy of corticosteroids as adjunct therapy in pediatric renal colic, with a focus on pain reduction, analgesic requirement, and spontaneous stone expulsion rates.
Methodology: A quasi-experimental study was conducted at the Department of Urology, Khyber Teaching Hospital Peshawar over a two-year period. A total of 121 children aged 5–15 years with ureteric stones ≤6 mm were included. Participants were allocated into two groups: one receiving corticosteroids (deflazacort) in combination with standard NSAID therapy, and the other receiving standard therapy alone. Pain intensity was measured using the Visual Analog Scale (VAS) at predefined intervals, and patients were followed for two weeks to assess stone passage.
Results: The mean age of participants was 12.5±2.3 years, with a slight male predominance (53%). The corticosteroid group demonstrated significantly greater pain reduction at all time points (p<0.01), reduced analgesic requirements, and a higher spontaneous stone expulsion rate (89% vs. 60%, p<0.01). Additionally, the mean time to stone passage was significantly shorter in the intervention group (3.2±1.3 days vs. 5.8±1.5 days, p<0.01). Adverse effects were minimal, with transient hyperglycemia observed in a small proportion of patients receiving corticosteroids.
Conclusion: Adjunct corticosteroid therapy significantly improves pain control, reduces analgesic dependency, and enhances spontaneous stone expulsion in children with renal colic. These findings support the potential role of corticosteroids as an effective adjunct in pediatric renal colic management.
Keywords: Corticosteroids, NSAIDs, Pain management, Pediatric urolithiasis, Renal colic, Stone expulsion.
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