Tamsulosin not effective for management of distal ureteral stones

January 01, 0001

Tamsulosin not effective for management of distal ureteral stones

The aim of the study by French investigators was to evaluate the efficacy and safety of the alpha-blocker tamsulosin hydrochloride in patients with ureteral colic owing to a distal ureteral stone. This was a multicenter, placebo-controlled, randomized, double-blind study. Patients with emergency admission for ureteral colic with a 2- to 7-mm-diameter radio-opaque distal ureteral stone were included in the study. They received tamsulosin (0.4 mg/d) or matching placebo until stone expulsion or day 42, whichever came first.

They found: "A total of 129 patients with acute renal colic were recruited from emergency wards between February 1, 2002, and December 8, 2006, in 6 French hospitals. Of these 129 randomized patients (placebo, 63; tamsulosin, 66), 7 were excluded from analyses: 5 for major deviations from inclusion criteria, 1 for stone expulsion before the first treatment administration, and 1 for consent withdrawal. At inclusion, mean stone diameters were 3.2 and 2.9 mm in the placebo and tamsulosin groups, respectively. Expulsion delay distributions during 42 days did not show any difference. The numbers of patients who spontaneously expelled their stone within 42 days were 43 of 61 (70.5%) and 47 of 61 (77.0%) in the placebo and tamsulosin groups, respectively. Corresponding delays were 10.1 and 9.6 (9.8) days. Other secondary end points and tolerance were not different between groups."

The authors concluded: "Although well tolerated, a daily administration of 0.4 mg of tamsulosin did not accelerate the expulsion of distal ureteral stones in patients with ureteral colic."

Not even a hint of effectiveness. Tamsulosin should not be prescribed for this purpose.

For the full abstract, click here.

Arch Intern Med 170(22):2021-2027, 13/27 December 2010
© 2010 to the American Medical Association
Tamsulosin Hydrochloride vs Placebo for Management of Distal Ureteral Stones-A Multicentric, Randomized, Double-blind Trial. Sébastien Vincendeau, Eric Bellissant, Alain Houlgatte, et al. Correspondence to Dr. Bellissant: Eric.Bellissant@univ-rennes1.fr

Category: U.Urinary. Keywords: tamsulosin, alpha-blockers, ureteral stones, urolithiasis, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 11 January 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.