Medical therapy for calculus disease

作者：Singh Shrawan K^*; Agarwal Mayank Mohan; Sharma Sumit

来源：BJU International, 2011, 107(3): 356-368.

DOI：10.1111/j.1464-410X.2010.09802.x

• calculus
• colic
• litholysis
• medical expulsive therapy
• medical management
• probiotics

Current knowledge on the subject of "medical stone management" is available in fractionated form. This study is a comprehensive and critical review of the literature and provides up-to-date information on the subject in concise and precise manner. The study highlights the role of medical therapy in various aspects of stone management, i.e. clearance of existing calculi by medical dissolution and facilitating expulsion, and prevention of recurrence.
Urolithiasis is a common problem with a high recurrence rate. Medical therapy directed to relieve agonizing pain, expulsion of stone, dissolution of uric acid and cystine stone and prevention of recurrence. NSAIDs are superior to opioids for renoureteral colic because their use doesn't induce vomiting and there is lesser requirement of rescue analgesia. In randomized trials, anticholinergics were not found to be beneficial. Alpha blockers, particularly tamsulosin, reduce pain and facilitate expulsion of stone and fragments of stone following extracorporeal shock wave lithotripsy (SWL) and ureterorenoscopic lithotripsy. Potassium citrate helps in chemodissolution of uric acid and cystine stones and is useful in prevention of stone recurrence in general and in those who have undergone SWL or percutaneious nephrolithotomy. Other measures for prevention of stone recurrence include fluid and dietary therapy, counteracting underlying metabolic abnormalities using suitable medications, phytotheurapeutic agents and probiotics. Once the role of nanobacteria is established in genesis of urinary stones, anti-nanobacteria therapy holds the promise of opening new horizons for prevention of urinary stones.

• 出版日期2011-2
• 单位河北医科大学