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Medical Expulsive Therapy Uncommon in Stone Disease

Treatment, which can prevent surgery, peaked at 3.9 percent of ER visitors in recent period

MONDAY, Dec. 21 (HealthDay News) -- Though the use of medical expulsive therapy (MET) increased for urinary stones in a recent period, it remained a seldom-used treatment, according to research published in the December issue of Urology.

John M. Hollingsworth, M.D., of the University of Michigan in Ann Arbor, and colleagues analyzed data on emergency room visits for stones from 2000 to 2006 from the National Hospital Ambulatory Medical Care Survey. The frequency of visits for urinary stone disease remained steady over this period.

The researchers found that the use of MET increased during this period, with the odds of receiving MET more than doubling each year (odds ratio, 2.15). Nevertheless, the overall prevalence of MET use over the period was 1.1 percent, and its use peaked at 3.9 percent in 2006. Based on previous findings, the low use of MET suggests that 1.6 million individuals during this period missed an opportunity to avoid stone surgery.

"Initial providers may still not be convinced of its efficacy, safety, or the proper balance of the two in certain populations. For example, the finding that women were prescribed MET less frequently than men suggests lack of information with regard to the safety of MET in these patients. Possibly, providers are concerned about providing MET to patients with a baseline low blood pressure," writes the author of an accompanying editorial.

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