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Medical ureteric stone expulsive therapy: How much success rate on it?

Medical ureteric stone expulsive therapy: How much success rate on it?
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

It is very common for me to taking care of ureteric stone pain’s patients with frequently ask questions from them on the medical therapy on stone expulsion. All answer will be arranged in Q&A below

Question : Is it possible to avoid endoscopic stone surgery?

  • Yes, it is! But you must be sure that you are free from these following emergency conditions.
    • The stone must be under control by pain killer
    • No sign of kidney failure due to the stone obstruction
    • No signs of life-threatening blood stream infection
Medical ureteric stone expulsive therapy: How much success rate on it?
Medical expulsive therapy has a chance to avoid Emergency endoscopic stone removal procedure.

Question : How much probability of the ureteric stone will be spontaneously pass out without any medication?

  • Depend on the size and location of the obstructed stone.
    • Size; 68% for < 5 mm and 47% for 5 – 10 mm.
    • Location; 48% for upper, 60% for mid-part and 75% for lower part of ureter.
Medical ureteric stone expulsive therapy: How much success rate on it?
Chance of passing stone is depended on several factors – size of stone, location of obstructed stone.

Question : How much chance is going to be increased when take the stimulating tablet for passing stone?

  • According to the reports from both US and European guidelines that 29% of chance will be increased after taking the tablet.

Question : Sound great! Any cons?

  • There is a chance that the ureteric stone pain is going to get worse when tablet itself effect on pushing the stone and for 4% of the tablet will remain its side effect like dizziness, headaches, nausea and vomiting.
Medical ureteric stone expulsive therapy: How much success rate on it?
4% of Dizziness was reported during medical expulsive therapy.

Question : Any parameter to measure how much successful rate for expulsive therapy?

  • Several parameters! Transverse stone diameter, longitudinal stone diameter, ureteral diameter, stone-to-bladder distance etc.
Medical ureteric stone expulsive therapy: How much success rate on it?
After carefully assess ureteric stone from CT scan, attending urologist can consider choice of medical expulsive therapy in specific patients.

During patients are taking the tablets, I always meet them regularly and workup with at least ultrasonography study checking that the stone is moving down or not. ONE IMPORTANT thing is do not take tablet by your own, because some serious complication might be occurred once you are not in a good hand taker. If you have any questions, please have a discussion with your trusted urologist and it would be my honor if you text me. Take care!

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