Medical expulsive therapy (MET) for ureteral stones involves the administration of pharmaceutical agents to facilitate passage of stones by ideally increasing the rate of passage and reducing time for expulsion. Several medications have been studied for this use. The most commonly studied off-label medications include α1-antagonists and calcium channel blockers. This article reviews the data available for the use of MET and controversies in the use of medications to aid stone passage based on more recent randomized controlled trials and meta-analyses. Based on the latest guidelines, α-blockers have been the most studied medication type and may have some benefit in the passage of distal ureteral stones greater than 4 mm in size.
This review contains 2 figures and 34 references.
Keywords: α1-antagonists, α-blockers, calcium channel blockers, medical expulsion therapy, phosphodiesterase inhibitors, ureteral stones
Comparison of Tamsulosin, Nifedipine, and Placebo for Ureteric Colic