{"id":4227,"date":"2021-10-01T08:00:00","date_gmt":"2021-10-01T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=4227"},"modified":"2026-05-18T09:51:09","modified_gmt":"2026-05-18T02:51:09","slug":"%d8%b7%d8%b1%d8%af-%d8%ad%d8%b5%d9%88%d8%a7%d8%aa-%d8%a7%d9%84%d8%ad%d8%a7%d9%84%d8%a8-%d8%b7%d8%a8%d9%8a%d8%a7","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/ar\/2021\/10\/01\/medical-ureteric-stone-expulsive\/","title":{"rendered":"\u0627\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0637\u0628\u064a \u0644\u0637\u0631\u062f \u062d\u0635\u0648\u0627\u062a \u0627\u0644\u062d\u0627\u0644\u0628: \u0645\u0627 \u0646\u0633\u0628\u0629 \u0627\u0644\u0646\u062c\u0627\u062d \u0641\u064a\u0647\u061f\ufffc"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" 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2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">It is very common for me to care for ureteric stone pain patients who have frequent questions about <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3897056\/\">medical expulsive therapy (MET)<\/a> for ureteric stones. Here are the answers in Q&amp;A format.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Q: Is it possible to avoid endoscopic stone surgery?<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Yes, it is possible \u2014 but only if all of the following emergency conditions are absent:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Pain is adequately controlled by pain medication<\/li>\n\n\n<li>No sign of kidney failure from stone obstruction<\/li>\n\n\n<li>No signs of life-threatening bloodstream infection (urosepsis)<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"4216\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/?attachment_id=4216\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Operation.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;3.2&quot;,&quot;credit&quot;:&quot;Wavebreak Media LTD&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark III&quot;,&quot;caption&quot;:&quot;Team of surgeons performing operation in operation theater at hospital&quot;,&quot;created_timestamp&quot;:&quot;1468061655&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;35&quot;,&quot;iso&quot;:&quot;400&quot;,&quot;shutter_speed&quot;:&quot;0.005&quot;,&quot;title&quot;:&quot;Team of surgeons performing operation in operation theater at hospital&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Medical expulsive therapy has a chance to avoid Emergency endoscopic stone removal procedure.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Medical expulsive therapy has a chance to avoid Emergency endoscopic stone removal procedure.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Operation.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Operation.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Ureteric stone medical expulsive therapy vs surgery\" class=\"wp-image-4216\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Operation.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Operation.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Operation.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Operation.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Operation.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Medical expulsive therapy may help avoid emergency endoscopic stone removal.<\/figcaption><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Q: How likely is a ureteric stone to pass spontaneously without medication?<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">It depends on the size and location of the obstructing stone:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>By size: 68% for stones &lt;5 mm; 47% for stones 5\u201310 mm<\/li>\n\n\n<li>By location: 48% for upper ureter; 60% for mid-ureter; 75% for lower ureter<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"4217\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/?attachment_id=4217\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?fit=5000%2C3333&amp;ssl=1\" data-orig-size=\"5000,3333\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;14&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS R&quot;,&quot;caption&quot;:&quot;a paper model of a human kidney with sand and stone, a stethoscope and a jar of urine tests on a blue background. kidney health concept&quot;,&quot;created_timestamp&quot;:&quot;1614593445&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;45&quot;,&quot;iso&quot;:&quot;250&quot;,&quot;shutter_speed&quot;:&quot;0.4&quot;,&quot;title&quot;:&quot;a paper model of a human kidney with sand and stone, a stethoscope and a jar of urine tests on a blue background. kidney health concept&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Chance of passing stone is depended on several factors &amp;#8211; size of stone, location of obstructed stone.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Chance of passing stone is depended on several factors &amp;#8211; size of stone, location of obstructed stone.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Ureteric stone spontaneous passage rate\" class=\"wp-image-4217\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?w=5000&amp;ssl=1 5000w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=1536%2C1024&amp;ssl=1 1536w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=2048%2C1365&amp;ssl=1 2048w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=1200%2C800&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?resize=1568%2C1045&amp;ssl=1 1568w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Ureteric-stone.jpg?w=2400&amp;ssl=1 2400w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Chance of passing a stone depends on size and location in the ureter.<\/figcaption><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Q: How much does medical expulsive therapy improve the stone passage rate?<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">According to US and European urological guidelines, medical expulsive therapy (typically alpha blockers such as Tamsulosin) increases the stone passage rate by approximately 29% compared to no medication.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Q: Are there any side effects of medical expulsive therapy?<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">There is a chance that ureteric pain may temporarily worsen as the medication facilitates stone movement. Approximately 4% of patients experience side effects including dizziness, headache, nausea, and vomiting.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"4218\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/?attachment_id=4218\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Dizziness.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;5.6&quot;,&quot;credit&quot;:&quot;Seva Levitsky&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark III&quot;,&quot;caption&quot;:&quot;People emotions, lifestyle and fashion concept. Distressed and exhausted asian woman close eyes and touching temples, having migraine, feeling headache or dizzy, yellow background.&quot;,&quot;created_timestamp&quot;:&quot;1591630852&quot;,&quot;copyright&quot;:&quot;Cookie Studio 2017&quot;,&quot;focal_length&quot;:&quot;70&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;People emotions, lifestyle and fashion concept. Distressed and exhausted asian woman close eyes and touching temples, having migraine, feeling headache or dizzy, yellow background&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"4% of Dizziness was reported during medical expulsive therapy.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;4% of Dizziness was reported during medical expulsive therapy.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Dizziness.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Dizziness.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Medical expulsive therapy side effects dizziness\" class=\"wp-image-4218\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Dizziness.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Dizziness.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Dizziness.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Dizziness.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Dizziness.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">4% dizziness reported during medical expulsive therapy.<\/figcaption><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Q: What parameters are used to assess stone passage success?<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Several CT-based parameters are assessed: transverse stone diameter, longitudinal stone diameter, ureteral diameter at the stone level, and stone-to-bladder distance. These help the urologist select the right patients for medical expulsive therapy vs. early endoscopic intervention.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"534\" data-attachment-id=\"4220\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/?attachment_id=4220\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Parameters.jpg?fit=1200%2C801&amp;ssl=1\" data-orig-size=\"1200,801\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Doctor checking x-ray results&quot;,&quot;created_timestamp&quot;:&quot;1498572884&quot;,&quot;copyright&quot;:&quot;Rawpixel Ltd.&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;200&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Doctor checking x-ray results&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"After carefully assess ureteric stone from CT scan, attending urologist can consider choice of medical expulsive therapy in specific patients.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;After carefully assess ureteric stone from CT scan, attending urologist can consider choice of medical expulsive therapy in specific patients.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Parameters.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Parameters.jpg?resize=800%2C534&#038;ssl=1\" alt=\"CT scan ureteric stone assessment\" class=\"wp-image-4220\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Parameters.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Parameters.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Parameters.jpg?resize=1024%2C684&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Parameters.jpg?resize=768%2C513&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/09\/Parameters.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">After carefully assessing the ureteric stone on CT scan, the urologist can select the appropriate patients for medical expulsive therapy.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">During the treatment period, I schedule regular follow-up visits with at least an ultrasound to check whether the stone is moving downward. <strong>Important:<\/strong> Do not take MET medications on your own without medical supervision, as serious complications can arise without proper monitoring.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You can visit my official homepage <a href=\"https:\/\/drsoaraweeurology.com\/\">here<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Ureteric Stone Medical Expulsive Therapy<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">What is medical expulsive therapy (MET) for ureteric stones?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Medical expulsive therapy (MET) is the use of oral medication \u2014 typically alpha blockers such as Tamsulosin \u2014 to relax the smooth muscle of the ureter, facilitating spontaneous passage of a ureteric stone without surgery. It is suitable for patients who are clinically stable (no sepsis, no kidney failure, adequate pain control) and who have stones likely to pass based on CT assessment of size and location.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What are the success rates for ureteric stones to pass with MET?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Without medication, the spontaneous passage rate is 68% for stones under 5 mm and 47% for stones 5\u201310 mm. Lower ureteric stones have a 75% spontaneous passage rate compared to 48% for upper ureteric stones. Adding medical expulsive therapy increases the overall passage rate by approximately 29% based on US and European guidelines, making it a meaningful adjunct to conservative management.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">When is medical expulsive therapy not appropriate?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">MET should not be used when there are emergency indications for immediate intervention: urosepsis (life-threatening urinary infection), acute kidney failure from bilateral obstruction or single kidney obstruction, or pain that cannot be controlled with medication. In these situations, urgent endoscopic intervention (ureteroscopy or ureteric stenting) takes priority over conservative management.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have ureteric stone pain and would like a specialist evaluation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Book a Consultation<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medical treatment.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@type\": \"FAQPage\",\n  \"mainEntity\": [\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What is medical expulsive therapy (MET) for ureteric stones?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"MET uses oral alpha blockers (e.g., Tamsulosin) to relax ureteral smooth muscle and facilitate spontaneous stone passage. It is suitable for stable patients with no sepsis, no kidney failure, and adequate pain control, with stones of appropriate size and location.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What are the success rates for ureteric stones to pass with MET?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Spontaneous passage: 68% for <5mm stones, 47% for 5-10mm. Lower ureter: 75%, upper ureter: 48%. MET increases passage rate by ~29% per US\/European guidelines.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"When is medical expulsive therapy not appropriate?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"MET is contraindicated with urosepsis, acute kidney failure from obstruction, or uncontrolled pain. These require urgent endoscopic intervention (ureteroscopy or ureteric stenting) instead.\"\n      }\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>It is very common for me to care for ureteric stone pain patients who have frequent questions about medical expulsive therapy (MET) for ureteric stones. Here are the answers in Q&amp;A format. Q: Is it possible to avoid endoscopic stone surgery? Yes, it is possible \u2014 but only if all of the following emergency conditions [&hellip;]<\/p>\n","protected":false},"author":185281453,"featured_media":10098,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Medical expulsive therapy (MET) for ureteric stones: success rates by size and location, alpha blocker benefits, and when surgery is needed. By Dr. Soarawee, Bangkok.","jetpack_seo_html_title":"Medical Expulsive Therapy for Ureteric Stone | Dr. Soarawee Bangkok","jetpack_seo_noindex":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1],"tags":[1384,1556,1555],"class_list":["post-4227","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kidney-stone","tag-kidney-stone","tag-medical-expulsive-therapy","tag-ureteric-stone-pain"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/Stone-Expulsive-Therapy.jpg?fit=1200%2C630&ssl=1","jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-16b","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/posts\/4227","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/comments?post=4227"}],"version-history":[{"count":14,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/posts\/4227\/revisions"}],"predecessor-version":[{"id":9709,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/posts\/4227\/revisions\/9709"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/media\/10098"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/media?parent=4227"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/categories?post=4227"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/tags?post=4227"}],"curies":[{"name":"\u0648\u0648\u0631\u062f\u0628\u0631\u064a\u0633","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}