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Medical expulsive therapy
The objective of this review article is to present the current literature on medical expulsive therapy (MET) and help guide practitioners in the appropriate use of MET for treatment of stone disease. Kidney stones can be treated with multiple modalities including medical therapy, ureteroscopy, shock...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897056/ https://www.ncbi.nlm.nih.gov/pubmed/24497685 http://dx.doi.org/10.4103/0970-1591.124209 |
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author | Wood, Kyle D. Gorbachinsky, Ilya Gutierrez, Jorge |
author_facet | Wood, Kyle D. Gorbachinsky, Ilya Gutierrez, Jorge |
author_sort | Wood, Kyle D. |
collection | PubMed |
description | The objective of this review article is to present the current literature on medical expulsive therapy (MET) and help guide practitioners in the appropriate use of MET for treatment of stone disease. Kidney stones can be treated with multiple modalities including medical therapy, ureteroscopy, shock wave lithotripsy (SWL), percutaneous nephrostolithotomy, open/laparoscopic stone removal, and/or combinations of these modalities. The choice of intervention depends on patient factors, anatomical considerations, surgeon preference, and stone location and characteristics. MET is an excellent treatment modality in the appropriately selected patient. The AUA/EAU guidelines suggest MET as a reasonable treatment choice in select patients. A review of the data suggests the use of alpha antagonist and calcium channel blockers can improve stone expulsion rates. Most data suggests alpha antagonists as superior to calcium channel blockers. There are numerous available alpha antagonists, all of which have supporting data for their use in MET. Evidence suggests that MET can decrease colic events, narcotic use, and hospital visits. MET may also reduce medical costs and prevent unnecessary surgeries and the associated risks. Further, there is a role for alpha antagonists and calcium channel blockers in improving stone passage and decreasing pain in those subjects treated with other modalities (i.e. SWL and ureteroscopy). Despite this evidence, MET remains underutilized as a treatment modality. |
format | Online Article Text |
id | pubmed-3897056 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-38970562014-02-04 Medical expulsive therapy Wood, Kyle D. Gorbachinsky, Ilya Gutierrez, Jorge Indian J Urol Symposium The objective of this review article is to present the current literature on medical expulsive therapy (MET) and help guide practitioners in the appropriate use of MET for treatment of stone disease. Kidney stones can be treated with multiple modalities including medical therapy, ureteroscopy, shock wave lithotripsy (SWL), percutaneous nephrostolithotomy, open/laparoscopic stone removal, and/or combinations of these modalities. The choice of intervention depends on patient factors, anatomical considerations, surgeon preference, and stone location and characteristics. MET is an excellent treatment modality in the appropriately selected patient. The AUA/EAU guidelines suggest MET as a reasonable treatment choice in select patients. A review of the data suggests the use of alpha antagonist and calcium channel blockers can improve stone expulsion rates. Most data suggests alpha antagonists as superior to calcium channel blockers. There are numerous available alpha antagonists, all of which have supporting data for their use in MET. Evidence suggests that MET can decrease colic events, narcotic use, and hospital visits. MET may also reduce medical costs and prevent unnecessary surgeries and the associated risks. Further, there is a role for alpha antagonists and calcium channel blockers in improving stone passage and decreasing pain in those subjects treated with other modalities (i.e. SWL and ureteroscopy). Despite this evidence, MET remains underutilized as a treatment modality. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC3897056/ /pubmed/24497685 http://dx.doi.org/10.4103/0970-1591.124209 Text en Copyright: © Indian Journal of Urology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Symposium Wood, Kyle D. Gorbachinsky, Ilya Gutierrez, Jorge Medical expulsive therapy |
title | Medical expulsive therapy |
title_full | Medical expulsive therapy |
title_fullStr | Medical expulsive therapy |
title_full_unstemmed | Medical expulsive therapy |
title_short | Medical expulsive therapy |
title_sort | medical expulsive therapy |
topic | Symposium |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897056/ https://www.ncbi.nlm.nih.gov/pubmed/24497685 http://dx.doi.org/10.4103/0970-1591.124209 |
work_keys_str_mv | AT woodkyled medicalexpulsivetherapy AT gorbachinskyilya medicalexpulsivetherapy AT gutierrezjorge medicalexpulsivetherapy |