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Medical expulsive therapy for ureteral stones: where do we go from here?

Medical expulsive therapy for ureteral stones: where do we go from here?
Medical expulsive therapy for ureteral stones: where do we go from here?

Despite two decades of clinical use, the effectiveness of medical expulsive therapy (MET) for the noninvasive management of patients with ureteral stones has, in the past year, been called into in question. The primary aim of MET is to expedite stone passage, although it has also shown effectiveness in reducing time to stone passage, thus reducing the incidence of colic episodes, improving stone clearance and improving patients' quality of life. At least 11 systematic reviews and meta-analyses have been published showing clinical benefits of MET; however, the results of these analyses have been challenged by data from two randomized controlled, multicentre trials with large patient cohorts, thus providing higher quality evidence that MET is ineffective in patients with ureteral stones. Results of the various systematic reviews and meta-analyses have suggested that MET is effective, however, such analyses incorporate the biases and limitations of smaller cohort studies, resulting in their conclusions being based upon lower-quality evidence. Evidence for the use of MET for small (<5 mm) distal ureteral stones has weakened based on clinical trial data published in 2015. However, MET might remain effective in the management of larger ureteral stones (>5 mm).

Journal Article, Review
2090-598X
608-612
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Aboumarzouk, Omar
3c7e2433-638d-4378-9931-902fdc68acce
Traxer, Olivier
2fa78817-b6f8-4f00-b389-c9c9ddbd01f3
Baard, Joyce
27bd223c-9448-444f-9ce4-7b1ac7750de5
Kamphuis, Guido
8479e4b3-ccdf-4841-b1d5-52f3b29d1c7b
de la Rosette, Jean
16ebd10e-bcc9-48e8-a433-212aa88f310f
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Aboumarzouk, Omar
3c7e2433-638d-4378-9931-902fdc68acce
Traxer, Olivier
2fa78817-b6f8-4f00-b389-c9c9ddbd01f3
Baard, Joyce
27bd223c-9448-444f-9ce4-7b1ac7750de5
Kamphuis, Guido
8479e4b3-ccdf-4841-b1d5-52f3b29d1c7b
de la Rosette, Jean
16ebd10e-bcc9-48e8-a433-212aa88f310f

Somani, Bhaskar K., Aboumarzouk, Omar, Traxer, Olivier, Baard, Joyce, Kamphuis, Guido and de la Rosette, Jean (2016) Medical expulsive therapy for ureteral stones: where do we go from here? Arab Journal of Urology, 13 (10), 608-612. (doi:10.1038/nrurol.2016.146).

Record type: Review

Abstract

Despite two decades of clinical use, the effectiveness of medical expulsive therapy (MET) for the noninvasive management of patients with ureteral stones has, in the past year, been called into in question. The primary aim of MET is to expedite stone passage, although it has also shown effectiveness in reducing time to stone passage, thus reducing the incidence of colic episodes, improving stone clearance and improving patients' quality of life. At least 11 systematic reviews and meta-analyses have been published showing clinical benefits of MET; however, the results of these analyses have been challenged by data from two randomized controlled, multicentre trials with large patient cohorts, thus providing higher quality evidence that MET is ineffective in patients with ureteral stones. Results of the various systematic reviews and meta-analyses have suggested that MET is effective, however, such analyses incorporate the biases and limitations of smaller cohort studies, resulting in their conclusions being based upon lower-quality evidence. Evidence for the use of MET for small (<5 mm) distal ureteral stones has weakened based on clinical trial data published in 2015. However, MET might remain effective in the management of larger ureteral stones (>5 mm).

Full text not available from this repository.

More information

e-pub ahead of print date: 2 August 2016
Published date: October 2016
Keywords: Journal Article, Review

Identifiers

Local EPrints ID: 419555
URI: https://eprints.soton.ac.uk/id/eprint/419555
ISSN: 2090-598X
PURE UUID: d93df618-68cb-4947-b9a5-cea28786a31e

Catalogue record

Date deposited: 13 Apr 2018 16:30
Last modified: 13 Mar 2019 18:44

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