Tamsulosin for Treatment of ED Patients with Renal Colic?

Tamsulosin, an α-adrenergic antagonist commonly used in the treatment of prostatic hypertrophy, has become a common treatment in the emergency department for renal colic caused by distal ureterolithiasis, based entirely on a small body of evidence that supports its use in the outpatient urology setting. In a prospective trial, 71 adult patients who presented to a single ED in Maine with renal colic caused by distal ureterolithiasis that was diagnosed by computed tomography (mean stone size, 3.6 mm) were randomized to receive 10 days of conventional outpatient therapy with ibuprofen and oxycodone alone or with tamsulosin (0.4 mg/day).

Spontaneous passage of ureteral stones at 14 days (the primary outcome) did not differ significantly between the tamsulosin and conventional-therapy groups (77% and 65% of patients, respectively). In addition, no significant differences were noted between groups in time to stone passage, self-reported pain scores, number of colicky pain episodes, unscheduled return ED or primary care visits, number of missed workdays, amount of analgesic used, or incidence of adverse events.