Online ISSN: 2515-8260

Keywords : Urolithiasis


Urolithiasis Updated Management Guidelines in Lower Ureters

Mohamad Omar Al Farouk Zaitoun, Lotfy Abd El-Latif Bendary, Diab El-Sayed Mohamed Ibrahim, Mohamed Ahmed Kamel Omran

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4383-4391

Background: Urinary calculi are one of the most common diseases of the urinary tract. The
prevalence rate has gradually increasedto 20% in recent decade. Medical expulsive therapy
(MET) has been discussed as a conservative treatment option in the management of distal
ureteral stones. Medical management therapy including alpha-blockers, calcium channel
blockers and phosphodiestrase5 (PDE5) inhibitors have been described. Stone passage through
the ureter is dependent on stone diameter and ureteral condition. In addition to ureteral spasm,
edema is an important factor in arresting ureteral stone passage. Alpha-blockers can inhibit
ureteral muscle contraction, reduce basal muscle tone and reduce peristaltic rate. The alpha-1
adrenergic blockers are most common used agents for MET. Silodosin may increase the rate of
stone expulsion rate and decrease the expulsion time.