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A recent meta-analysis of 9 studies that included 700 patients supported the use of α-blockers or calcium-channel blockers to facilitate passage of ureteral stones (Journal Watch Oct 26 2006). In a new and updated meta-analysis, investigators included 22 randomized trials involving nearly 2000 patients, most of whom had distal ureteral stones ≥5 mm in diameter.
Tamsulosin (Flomax) was the most commonly used α-blocker. Time to stone passage was shortened by an average of 2 to 6 days in the α-blocker groups compared with controls, and α-blocker recipients were more likely than controls to pass stones without need for additional intervention (risk ratio, 1.59). Findings were similar in the calcium-channel blocker trials, all of which used nifed…