J Endourol. 2009;23:387-393

Medical expulsive therapy (MET) following shockwave lithotripsy (SWL) results in a significant increase in successful treatment outcomes, according to Canadian researchers. 

Their finding comes from a systematic review and meta-analysis of four trials that included a total of 212 patients who received MET and 206 who received placebo following SWL. MET agents used in the trials were tamsulosin, nifedipine, and Phyllanthus niruri extract.


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Trevor D. Schuler, MD, and colleagues at St. Michael’s Hospital in Toronto found that the use of MET following SWL increased the likelihood of a successful outcome by 17%. For stones larger than 10 mm, post-SWL MET increased that likelihood by 26%.

“Medical expulsive therapy to assist in the passage of stone fragments created by shockwave lithotripsy appears well tolerated and results in significant increases in successful outcomes,” the authors concluded.