Munich, Germany (UroToday.com) Lifetime risk of urolithiasis is estimated to be around 5% with recurrence rate of almost 50%. Currently 7% of males and 10% of females in United States have urolithiasis. Furthermore, the incidence and prevalence of kidney stones is increasing providing significant economic burden. Urolithiasis has multiple treatment options including medical and surgical managements depending on multiple stone and patients characteristics. Medical expulsive therapy is a topic of debate and its role in the management of ureteral stones has been extensively evaluated and still remains questionable.
Plenary session chaired by Drs. N’dow and Joan Palou consisted of debates of high importance for practicing urologists. First debate on ureteral stone management and role of medical expulsive therapy (MET) was a highlight of the day. Professor Christian Steiz defended the role of MET and Professor McClinton argued we should abandon the MET and that is not only useless but causes a harm to the patient. Both debaters provided an extensive coverage of the existing literature on effectiveness, safety and side effects of variety MET for ureteral stones.
Despite the heated debate both sides agreed that if the MET is indicated it should be selectively prescribed for patients with less than 5 mm ureteral stones but again, given that most of these stones pass spontaneously the role of MET is probable minimal. The use of MET in larger stones has been shown to be ineffective.
Both debaters concluded that existing literature is not sufficient to draw a line on the topic and that future studies are needed to fully elucidate the role of MET in patients with ureteral stones.
Presented By:
Pro: Medically induced stone passage: Are the EAU guidelines wrong?
C.C. Seitz.
Con: Medically induced stone passage: Are the EAU guidelines wrong?
McClinton
From the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany