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01.04.2009 | Review Article

Medical Expulsive Therapy for Distal Ureteral Stones

verfasst von: Vassilios Tzortzis, Charalampos Mamoulakis, Jorge Rioja, Stavros Gravas, Martin C. Michel, Prof. Dr Jean J. M. C. H. de la Rosette

Erschienen in: Drugs | Ausgabe 6/2009

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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 α-adrenergic receptor antagonists (α-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 α-blockers or nifedipine. Corticosteroids may provide a small additive effect when combined with either α-blockers or nifedipine.

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Titel: Medical Expulsive Therapy for Distal Ureteral Stones
verfasst von: Vassilios Tzortzis
Charalampos Mamoulakis
Jorge Rioja
Stavros Gravas
Martin C. Michel
Prof. Dr Jean J. M. C. H. de la Rosette
Publikationsdatum: 01.04.2009
Verlag: Springer International Publishing
Erschienen in: Drugs / Ausgabe 6/2009
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI: https://doi.org/10.2165/00003495-200969060-00003

Springer Medizin

Abstract

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