Medical Expulsive Therapy for Distal Ureteral Stones

Overview

Journal Drugs

Specialty Pharmacology

Date 2009 May 2

PMID 19405549

Citations 15

Authors

Vassilios Tzortzis

Charalampos Mamoulakis

Jorge Rioja

Stavros Gravas

Martin C Michel

Jean J M C H de la Rosette

Affiliations

Soon will be listed here.

Abstract

Although minimally invasive treatments for ureteral stones are efficacious, they are not free of complications and are associated with high cost. Medical expulsive therapy (MET) has recently emerged as an alternative strategy for the initial management of small distal ureteral stones. A MEDLINE search was undertaken to evaluate all currently available data on efficacy and safety of MET therapy in such patients. The specific mechanism of action on the ureteral smooth muscle and the emerging evidence of the efficacy (defined as either an increase in expulsion rate or a decrease in time to expulsion) and low-risk profile suggest that alpha-adrenergic receptor antagonists (alpha-blockers) and calcium channel antagonists should be the initial medical treatment in patients amenable to conservative therapy. NSAIDs and anticholinergics have not shown efficacy as single agents or in combination with alpha-blockers or nifedipine. Corticosteroids may provide a small additive effect when combined with either alpha-blockers or nifedipine.

Citing Articles

Evaluation of the efficacy and safety of either or both mirabegron and silodosin, as a medical expulsive therapy for distal ureteric stones.

Abdel-Kader M, Sayed A, Sayed S, AbdelRazek M Int Urol Nephrol. 2023; 56(5):1605-1610.

PMID: 38041752 PMC: 11001674. DOI: 10.1007/s11255-023-03880-y.

Adrenoceptors in the Lower Urinary Tract.

Hennenberg M, Michel M Handb Exp Pharmacol. 2023; 285:333-367.

PMID: 37455288 DOI: 10.1007/164_2023_678.

Active metabolic lithiasis: A condition that requires proper evaluation and monitoring.

Pricop C, Ivanu A M, Puia D Exp Ther Med. 2022; 24(6):715.

PMID: 36349061 PMC: 9634907. DOI: 10.3892/etm.2022.11651.

Evolving Role of Silodosin for the Treatment of Urological Disorders - A Narrative Review.

Jindan L, Xiao W, Liping X Drug Des Devel Ther. 2022; 16:2861-2884.

PMID: 36051157 PMC: 9427207. DOI: 10.2147/DDDT.S373659.

The safety and efficacy of doxazosin in medical expulsion therapy for distal ureteric calculi: A meta-analysis.

Yu B, Zheng X, Sun Z, Cao P, Zhang J, Gao Z PLoS One. 2021; 16(1):e0245741.

PMID: 33493214 PMC: 7833139. DOI: 10.1371/journal.pone.0245741.

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