Urolithiasis Updated Management Guidelines in Lower Ureters
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 3, Pages 4383-4391
Abstract
Background: Urinary calculi are one of the most common diseases of the urinary tract. Theprevalence 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.
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