Efficacy and Safety of Boldine Combined with Phyllanthus niruri and Ononis spinosa in Medical Expulsive Therapy for Distal Ureteral Stones with Renal Colic: A Single-Center, Retrospective Cohort Study

<i>Background and Objectives</i>: This study aimed to compare the effects and safety of boldine combined with <i>Phyllanthus niruri</i> and <i>Ononis spinosa</i> plus tamsulosin vs. tamsulosin alone in medical expulsive therapy (MET) for distal ureteral calculi. <i>Materials and Methods</i>: This retrospective cohort study was conducted on 159 renal colic patients with distal ureteric stones (≤10 mm). Patients aged between 18 and 70 years or older with distal ureteral (below the sacroiliac joint) stones ≤10 mm (defined by the largest diameter in three planes) confirmed by urinary ultrasonography and/or native computed tomography (CT). Patients were divided into two groups: A and B. Patients in Group A received tamsulosin 0.4 mg plus boldine combined with <i>Phyllanthus niruri</i> and <i>Ononis spinosa</i>, while those in Group B received tamsulosin 0.4 mg. The rate of stone expulsion, duration of stone expulsion, the dose and the duration of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesic use, and adverse effects of drugs were recorded. <i>Results</i>: No differences were reported in demographic profiles between the two groups. The stone expulsion rate in Group A (84.8%) was higher in comparison to Group B (52.5%); the mean time of stone expulsion was 16.33 ± 4.75 days in Group A and 19.33 ± 6.42 days in Group B. The mean requirement time of analgesia was significantly less in Group A, 2.42 ± 2.56, than in Group B, 6.25 ± 3.05. Drug-related adverse effects (headache, dizziness, nausea, vomiting, postural hypotension, backache, and running nose) were comparable between the two groups. <i>Conclusions</i>: Tamsulosin plus boldine combined with <i>Phyllanthus niruri</i> and <i>Ononis spinosa</i> as medical expulsion therapy is more effective for distal ureteric stones with less need for analgesics and a shorter stone expulsion time than tamsulosin alone.