Indian Journal of Urology
: 2014  |  Volume : 30  |  Issue : 1  |  Page : 60--64

Medical expulsive therapy

Kyle D Wood, Ilya Gorbachinsky, Jorge Gutierrez 
 Department of Urology, Wake Forest Baptist Health, Winston Salem, NC, USA

Correspondence Address:
Kyle D Wood
Urology Resident, Wake Forest Baptist Health, Department of Urology, Medical Center, Boulevard, Winston Salem, NC 27157, NC

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.

How to cite this article:
Wood KD, Gorbachinsky I, Gutierrez J. Medical expulsive therapy.Indian J Urol 2014;30:60-64

How to cite this URL:
Wood KD, Gorbachinsky I, Gutierrez J. Medical expulsive therapy. Indian J Urol [serial online] 2014 [cited 2021 Sep 19 ];30:60-64
Available from:;year=2014;volume=30;issue=1;spage=60;epage=64;aulast=Wood;type=0