Medical Expulsive Therapy Articles

Articles

  • "What is the Role of Alpha Blockers for Medical Expulsive Therapy? Results From a Meta-Analysis of 60 Randomised Trials and Over 9500 Patients".

    Use of α-blockers for medical expulsive therapy (MET) has been the subject of huge debate in Urology. Moreover, there have been a number of randomised controlled trials (RCTs) with differing results.

    Published April 15, 2018
  • Alpha-Adrenergic Blockers with or without Deflazacort for the Expulsion of a Lower Ureteric Calculus ≤ 10 mm: A Comparative Study

    ABSTRACT

    Introduction: A lower ureteric calculus is one of the most commonly encountered conditions in daily urological practice. There are various options for management of lower ureteric calculus, which includes watchful waiting, extracorporeal shock wave lithotripsy (ESWL), and ureteroscopic lithotripsy (URSL). The aim of our study was to evaluate the efficacy of following drugs in the expulsion of a lower ureteric calculus ≤ 10 mm. The drugs used are (1) tamsulosin, (2) naftopidil, (3) tamsulosin and deflazacort, and (4) naftopidil and deflazacort.

    Methods: A prospective study was carried out in the Department of Urology from August 2012 to January 2013. A total of 150 patients were enrolled and were randomized into 5 equal groups of 30: A (control), B (naftopidil), C (tamsulosin), D (naftopidil and deflazacort), and E (tamsulosin and deflazacort). Complete hemograms; blood urea; serum creatinine; urine routine examination and culture and sensitivity; X-ray of the kidney, ureter, and bladder (KUB); and/or ultrasonography were done in all cases. Cases were followed up to 30 days or upon spontaneous passage of the calculus, whichever was earlier. X-ray KUB and/or ultrasonography were done to confirm the passage of the stone.

    Results: The expulsion rate for a calculus ≤ 10 mm was statistically significant in all the groups in comparison to the control group. The mean days of expulsion and use of analgesics was also low in all the groups compared to control. Amongst all groups, the stone expulsion rate was highest, and episodes of pain and mean days of expulsion were lowest for the D group.

    Conclusion: It is concluded that alpha-adrenergic blockers facilitate the expulsion of lower ureteric stones ≤ 10 mm and decreases the episodes of colic, which is further improved by the addition of deflazacort. Naftopidil plus deflazacort gives the best results in regards to stone expulsion rates, mean days of expulsion, and episodes of colic.


    Mandeep Phukan, Debanga Sarma, Rajeev T. Puthenveetil, Sasanka K. Barua, Saumar J. Baruah

    Department of Urology, Gauhati Medical College, Bhangagarh, Guwahati, Assam, India

    Submitted August 28, 2013 - Accepted for Publication September 27, 2013


    KEYWORDS: Lower ureteric calculus, medical expulsive therapy, alpha-adrenergic blocker

    CORRESPONDENCE: Mandeep Phukan, Department of Urology, Gauhati Medical College, Bhangagarh, Guwahati, Assam, India 781032 ()

    CITATION: UroToday Int J. 2013 October;6(5):art 62. http://dx.doi.org/10.3834/uij.1944-5784.2013.10.09

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    Published October 25, 2013
  • Design and challenges of a randomized clinical trial of medical expulsive therapy (tamsulosin) for urolithiasis in the emergency department.

    Urolithiasis or urinary stone disease has been estimated to affect about 1 in 11 Americans. Patients with urinary stone disease commonly present to the emergency department for management of their acute pain.

    Published December 26, 2016
  • EAU Guidelines on Interventional Treatment for Urolithiasis.

    Management of urinary stones is a major issue for most urologists. Treatment modalities are minimally invasive and include extracorporeal shockwave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PNL).

    Published September 21, 2015
  • Medical Expulsive Therapy for Urinary Stones: Future Trends and Knowledge Gaps.

    Medical expulsive therapy (MET) for ureteral stones has become a controversial area due to the contradictory results of high-quality trials and meta-analyses.

    We aimed to review the literature to evaluate the value of and future directions for MET for ureteral stone disease.

    Published August 25, 2019
  • Perinatal Outcomes with Tamsulosin Therapy for Symptomatic Urolithiasis.

    Medical expulsive therapy (MET) represents an effective adjunctive treatment for nonpregnant patients with symptomatic urolithiasis. Tamsulosin is classified by the FDA as a category B medication; however no published data exists for human pregnancy.

    Published August 27, 2015
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