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Several small clinical trials have suggested that the likelihood that patients will pass ureteral stones spontaneously can be increased by calcium-channel blockers or α-adrenergic blockers. Both of these drug classes are thought to relax ureteral smooth muscle in the region of the stone.
Investigators performed a meta-analysis of nine diverse trials in which 693 patients with ureteral stones (mean diameter, 3.9 to 7.8 mm) were randomized to receive calcium-channel blockers, α-blockers, or no expulsive therapy for 1 to 6 weeks and were followed for 15 to 48 days. In three trials, treated patients received corticosteroids in addition to nifedipine; in seven trials, both treated and control groups received nonsteroidal anti-inflammatory drugs (…