A 45-year-old man presents with a 6 mm stone in the proximal ureter. He has no fever and normal renal function. What is the most appropriate initial management?
- A Medical expulsive therapy with alpha-blocker ✓
- B Emergency ureteroscopy
- C Extracorporeal shock wave lithotripsy (ESWL)
- D Percutaneous nephrolithotomy (PCNL)
Correct answer: A. Medical expulsive therapy with alpha-blocker
Explanation
Stones <10 mm in the ureter are managed conservatively with medical expulsive therapy (MET) using alpha-blockers like tamsulosin, provided there is no sepsis or intractable pain. ESWL and ureteroscopy are reserved for stones failing MET or >10 mm. PCNL is for large renal stones.
Reference: Smith's Textbook of Endourology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.