Factors Influencing the Success of Medical Expulsive Therapy for Lower Ureteric Stones: An Observational Study

Abstract Purpose: This study aimed to assess the factors influencing the success of Medical Expulsive Therapy (MET) in managing lower ureteric stones, with particular focus on stone size, location, and patient-specific characteristics. Methodology: A prospective observational study was conducted at Gandhi Medical College and Hamidia Hospital, Bhopal, from August 2022 to December 2023. A total of 107 patients aged 18-50 years with lower ureteric calculi (5-10 mm), confirmed via ultrasonography (USG) and non-contrast computed tomography (NCCT), were included. Patients with pregnancy, solitary kidney, severe comorbidities, or opting for immediate surgery were excluded. MET treatment included hydration, NSAIDs, and alpha-blockers. Patients were reassessed at 2 and 4 weeks, with MET success defined as spontaneous stone passage within 4 weeks. Results: The study cohort had a mean age of 35.17 years, with 72.9% male participants. The majority of stones were located in the left distal ureter (56.1%). The mean stone size was 6.92 mm (SD=1.26). The overall MET success rate was 86.9%. Stone size was the most significant predictor of MET success, with smaller stones (<8 mm) exhibiting higher spontaneous passage rates. No significant associations were found between MET success and age and gender. Conclusion: MET is an effective conservative treatment for lower ureteric stones, particularly for stones smaller than 8 mm. Stone size is the most critical factor influencing treatment success. This study supports the use of MET as a first-line treatment for lower ureteric stones, especially in resource-limited settings.