Medical Expulsive Therapy (MET) for Ureteral Calculi in Children: Systematic Review and Meta-Analysis

Background Medical expulsive therapy (MET) is the use of medication to facilitate ureteral stone passage prior surgical intervention. Practice guidelines for MET in pediatric population remain limited, primarily due a scarcity randomized controlled trials and concerns regarding dosing side effects. To address this, we conducted systematic review meta-analysis clarify impact on spontaneous stones located within distal ureter. Methods A narrow scope search using PubMed Embase with predefined strategy was performed September 2021 identify all involving Raw data from 6 eligible articles were extracted pooled analysis. Our primary outcome overall effect calculi 28 days compared controls. Results The mean age patients included studies 7.6 years-old, range ages 2–18 years old. In analysis studies, 235 received 176 placebo. size 6.40 mm treatment arm 6.42 control arm. Children receiving more likely than controls experience [Relative risk 1.39 (CI 95% 1.21–1.60)]. Considering only one child treated withdrew Conclusion demonstrates statistically significant benefit. benefits are diverse include, possibly, minimizing exposure anesthesia radiation alongside improving outcomes if ureteroscopy must be performed. Given increasing incidence children nuances inherent surgery smaller anatomy, represents an opportunity safer effective management.