smooth muscle relaxants are necessary for the elimination of small stones from the kidney through the ureter, and when they arrive to bladder they need open way to pass through the urethra, but the smooth muscle relaxation of bladder "detrusor muscle" cause urine retention, so the first step of elimination of kidney stone is good "passing from kidney through ureter to the bladder" ...while the second step seems bad "passing from bladder to urethra" because the bladder is relaxed and tends to store more urine, how it is possible to accelerate the second step of the elimination of kidney stone from the bladder?
Hi Ammar
Alpha-blockers are a type of medication that can speed up stone passage, decrease pain, and decrease the risk of surgery. The two that have been studied the most are Flomax® (tamsulosin) and Uroxatral® (alfuzosin Hydrochloride).
https://my.clevelandclinic.org/health/transcripts/1176_kidney-stones
Stone size of ≤ 8 mm2 are the patients in whom Alfa-blockers like Tamsulosin or alfuzosin can be given along with medication to prevent infection and pain. Tamsulosin 0.4 mg daily orally for 4 weeks. Additionally, these patients received conventional treatment with daily hydration of 2500 mL and ciprofloxacin (500 mg orally, twice a day) for the first 7 days. Diclofenac sodium (50 mg orally, twice a day)
and spasmolytic (hyoscine butylbromide, 10 mg orally, three times a day) were also given to this patients to get optimum results..
The mechanism of stone elimination from the kidney or ureter is completely different from that of the urinary bladder due to anatomical and pathophysiological considerations. No data support the use of such medications for bladder stones. Therefore, it depends on the stone size, multiplicity and chemical composition where spontaneous passage with excessive diuresis or chemolysis may have a role. The latter is better to be used through a urethral catheter to have a good concentration within appropriate time. Otherwise, minimally invasive intervention would be indicated.
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