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Year : 2017  |  Volume : 4  |  Issue : 4  |  Page : 91-95

Medical therapy for primary expulsion of urinary calculi: A review

1 Department of Internal Medicine, College of Medicine, University of Bisha, Kingdom of Saudi Arabia
2 Department of Surgery, Bayero University, Kano, Nigeria

Correspondence Address:
Dr. Mushabab A Al-Ghamdi
Department of Internal Medicine, College of Medicine, University of Bisha, PO Box 60, Bisha
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ssajm.ssajm_33_17

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Urinary calculi are relatively common worldwide. Open surgical removal and minimally invasive surgery are effective in treating calculi but are associated with a cost and significant complications. In addition, extracorporeal shock waves lithotripsy and minimally invasive surgery are not widely available in resource-limited countries. Medical treatments for expulsion of urinary calculi provide noninvasive, relatively cheaper and safer alternatives to open surgery as well as to minimally invasive surgery for small stones. However, these modes of therapy are not widely used despite mounting evidence of their efficacy. The aim of this review is to appraise the existing literature on medical therapies for primary expulsion of urinary calculi. We searched Medline, EMBASE, CINAHL, AJOL and Cochrane database, for randomized controlled trials on urinary calculi using the search terms “urinary calculi” (MESH for Medline) AND “expulsion” OR medical treatment. We also searched reference list of relevant articles. The literature was appraised and summarized in this review. Twenty-seven randomized controlled trials on medical therapies for expulsion of urinary stones were found from various databases and hand-search of references of articles. We also retrieved some basic science, epidemiologic, and meta-analytic research related to urinary calculi. Medical expulsive therapies, especially alpha-blockers and calcium channel blockers have been shown to be effective in many trials as well as meta-analysis of clinical trials. We conclude that medical therapies for primary expulsion of small size urinary calculi should be considered in suitable patients, especially in resource-limited settings where facilities for shockwave lithotripsy (SWL) and minimally invasive surgeries are not readily available.

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