Maximizing Chances of Ureteral Stone Passage with Medically Expulsive Therapy
Treatment options for ureteral stones that are 6-7 mm or smaller include an attempt to pass the stone (medical expulsive therapy). Stones that are smaller than 0.6-0.7 mm end all located in distal ureter have a very good chance of spontaneous passage which can be accelerated with medications such as Flomax
Typically, it is safe to wait for stone to pass for up to 4 weeks. If the stone does not pass within 4 weeks, the procedure to break and remove the stone is indicated.
While drinking an adequate amount of fluids is important, forced drinking probably does not help stone passage.
Who is a Candidate for Passing Stones with Medically Expulsive Therapy?
Healthy men and women (including pregnancy women) as well as children who are old enough to communicate their feelings and needs can be offered medically expulsive therapy.
Who is NOT a Candidate for Passing Stones Spontaneously?
Patients who have symptoms of urinary tract infection, those with acute or chronic renal insufficiency, patients with solitary kidney are not good candidates for medical expulsive therapy and typically require one of the other options for treatment of ureteral stones including ureteral stenting, ureteroscopy with laser lithotripsy or ESWL.
Dr. Alex Shteynshlyuger is a board certified urologist in NYC who specializes in treating men and women with kidney stones and ureteral stones.