Medical Expulsive Therapy in Urolithiasis: Evidence- Based Applications of Alpha Blockers and Calcium Channel Blockers in Calculi

Urolithiasis is a common condition that can cause severe pain and urinary obstruction. Medical expulsive therapy (MET) has emerged as an effective conservative approach for facilitating spontaneous passage of ureteral stones, particularly those located in the distal ureter. Alpha-adrenergic blockers such as Tamsulosin and calcium channel blockers such as Nifedipine reduce ureteral smooth muscle tone and spasm, thereby improving stone expulsion rates and decreasing colic episodes.

This chapter reviews the pharmacological basis, clinical evidence, indications, and limitations of medical expulsive therapy. It highlights the role of alpha blockers and calcium channel blockers in improving patient outcomes while reducing the need for surgical intervention in selected patients with ureteric calculi.