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Health Care

An Appeal to Raise a Concern about Medical Expulsive Treatment


19 October 2022.

The Editor

Star Tribune,

170 Star Lane, Wyoming.

Subject: An Appeal to Raise a Concern about Medical Expulsive Treatment

Dear Editor,

I have read an amazing and informative review article published in “The Turkish Journal of Urology” entitled “Medical Expulsive Treatment (MET) for Ureteral Stones” written by famous writers Tuncel A and Atan A. First and foremost, I want to congratulate the writers of this successful article whole-heartedly that they have made some contributions to the field of Urology. It made me enthusiastic to write about the effectiveness of medical expulsive therapy to bring its significance to people, especially pediatric patients. The article explicitly explained in a clear and detailed manner that medical expulsive treatment expedites stone passage and thus improves stone clearance by reducing the incidence of colic episodes in patients with prolonged renal dysfunction. Moreover, the treatment also improves the quality of patients’ life by managing larger ureteral stones up to 5mm through MET. The article also depicted that Medical Expulsive Treatment (MET) is a cost-effective alternative for the expulsion of lithiasis to other active options of treatment.

In the article, Atan and Tuncel indicated that patients with prolonged renal dysfunction due to active urinary system infection, hydronephrosis, solitary kidney, and obstruction in the urinary tract are not generally exposed to medical expulsive therapy. The article also indicated that mariners and pilots are most vulnerable to such renal problems. However, I suggest that Journal should include pediatric patients and pregnant mothers in the patient group curated in the review article. Pregnant and pediatric patients do not seem to be suitable for the expulsive therapy treatment because the safety and efficacy of the treatment method have not been indicated and established yet in such patients with calcium channels and alpha-blockers. The groups of pediatric patients who have prolonged problems with idiopathic urethritis and neuropathic bladder have a possible chance of voiding dysfunction. Therefore, it is not recommended to have expulsive therapy treatment as a suitable alternative. The European Association of Urology, moreover, recommends that pediatric patients with ureteral stones should not have medical expulsive therapy treatment.

Hope you will inscribe the above.

Thank you.

Yours Truly,




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