Urolithiasis - Medical therapies.

Abstract

This review paper provides a summary of medical therapies available for urolithiasis. The summary includes general medical advice, prophylactic medications, dissolution therapy and medical expulsion therapy. The paper is designed to provide a management strategy for all physicians who treat urolithiasis, from general practitioners, to emergency physicians, to urologists. OBJECTIVE To provide an up to date review of the literature in relation to the medical management of stone disease. This will encompass prophylaxis, dissolution therapy and medical expulsion therapy. PATIENTS AND METHODS First-time stone formers do not regularly have a full urine and electrolyte evaluation due to the low incidence of a reversible metabolic cause. However, stone disease is common and over a lifetime urolithiasis can affect up to 10-15% of the population. RESULTS Medical management of stone disease encompasses preventative measures, medical dissolution and medical expulsion therapy. CONCLUSIONS Recurrent stone formers should have dietary optimization to decrease the risk of further stones. Furthermore, the correct use of prophylactic and therapeutic medications can decrease the morbidity associated with ureteric calculi. © 2011 BJU INTERNATIONAL.