Medical Expulsive Therapy Fails to Improve Ureteral Stone Passage
kidney stone, small stone, kidney, stones, AUA 2017, urology, nephrology
Medical expulsive therapy (MET) does not improve spontaneous stone passage (SSP) in patients with acute ureteric colic, according to findings presented at the 33rd European Association of Urology Congress in Copenhagen, Denmark.
As part of the MIMIC study, Taimur T. Shah, MBBS, MRCS, of University College London, and colleagues collected data from 4181 patients admitted with acute ureteric colic. Of these, 3127 (75%) were discharged with conservative management, and 2516 of them (80%) had confirmed SSP. In this group, 952 patients (44%) were prescribed MET in the form of tamsulosin and 1234 (56%) were not. The rate of SSP was 78% and 72%, respectively. On multivariable analysis, which included adjustment for stone size and position, the investigators found no significant difference in SSP.
All patients included in the study had acute renal colic with an obstructing ureteral stone confirmed by computed tomography of the kidneys, ureters, and bladder.
A previous double-blind, placebo-controlled study published online in November 2017 in European Urology found that tamsulosin improves passage of distal ureteral stones greater than 5 mm in maximum diameter. In this group of patients, the expulsion rates were 87% among tamsulosin-treated patients compared with 75% among placebo recipients, a significant difference between the groups. The investigators found no significant difference between treatment arms among patients with distal ureteral stones smaller than 5 mm in maximum diameter.
Shah TT, Gao C, O'Keefe A, et al. Medically expulsive therapy (MET) has no benefit in improving spontaneous stone passage (SSP) in patients presenting with ureteric colic: Results from the MIMIC study. Data presented at the 33rd European Association of Urology Congress held in Copenhagen, Denmark, from March 16 to 20.