Another Trial of Tamsulosin for Patients with Ureteral Stones

The efficacy of α-blockers (e.g., tamsulosin) to facilitate passage of ureteral stones is unclear. In a 2014 meta-analysis of mostly small studies, tamsulosin shortened time to stone passage, but study quality was not rated highly (Cochrane Database Syst Rev 2014; 4:CD008509). In a subsequent large trial, tamsulosin was not superior to placebo, but stone passage was not confirmed by imaging (NEJM JW Gen Med Jul 1 2015 and Lancet 2015; 386:341).

Now, in a double-blind, randomized trial conducted in five Australian emergency departments, 403 adults with computed tomography (CT)–confirmed distal ureteral stones received daily tamsulosin (0.4 mg) or placebo for 28 days. Stone size was <5 mm in 74% of patients and 5 to 10 mm in 26%; patients were…