Medical Expulsive Therapy after Extracorporeal Shock Wave Lithotripsy: A Systematic Review and Network Meta-Analysis.
Yonsei Med JSep 24, 2026
Clinical ResearchUrology
Young Joon Moon, Jae Yong Jeong, Dong Hyuk Kang et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated the efficacy and safety of pharmacological interventions for medical expulsive therapy (MET) after extracorporeal shock wave lithotripsy (ESWL) in 3262 patients across 21 randomized controlled trials. The tamsulosin-tadalafil combination was found to be the most effective strategy with a surface under the cumulative ranking curve (SUCRA) of 93.8%.
Key findings
- The tamsulosin-tadalafil combination had a SUCRA of 93.8%, indicating high effectiveness.
- Tamsulosin-corticosteroid and boron supplementation followed with SUCRAs of 78.2% and 67.9%, respectively.
- Silodosin, while effective for single stones, ranked low at 20.9% in the post-ESWL context.
- All pharmacological agents demonstrated acceptable safety profiles without significant serious adverse events.
Why it matters
Understanding the most effective pharmacological strategies for MET after ESWL can enhance patient outcomes by improving stone-free rates and minimizing complications, which is crucial for effective post-operative care.