Tamsulosin does not appear to promote urinary stone passage

Andrew C. Meltzer, M.D., from the George Washington University School of Medicine & Health Sciences in Washington, D.C., and colleagues randomized 512 patients presenting in an emergency department with symptomatic urinary stone in the ureter (<9 mm in diameter) to treatment with either tamsulosin (0.4 mg) or placebo daily for 28 days.

The researchers found that stone passage rates were 50 percent in the tamsulosin group and 47 percent in the placebo group (relative risk, 1.05; 95.8 percent confidence interval, 0.87 to 1.27; P = 0.60). No secondary outcomes (time to stone passage, return to work, use of analgesic medication, hospitalization, surgical intervention, and repeated emergency department visit) were significant.

“For emergency department patients who present with renal colic owing to ureteral stones smaller than 9 mm, tamsulosin does not appear to promote stone passage,” the authors write. “Guidelines for medical expulsive therapy for urinary stones may need to be revised.”