Tamsulosin to treat uncomplicated distal ureteral calculi: a double blind randomized placebo-controlled trial

To evaluate efficacy and outcome of tamsulosin therapy for 4 mm-10 mm uncomplicated distal ureteral stones.

A total of 150 patients (adults with newly diagnosed single unilateral distal ureteral 4 mm-10 mm stones) were double blindly randomized into GA or GB. All patients received traditional treatment of hydration and analgesia as needed. Additionally, patients received either placebo (GA) or 0.4 mg tamsulosin (GB) oral tablets once daily. Treatment and follow up were continued for up to 4 weeks. Endpoints were spontaneous stone passage rates (SPR) and passage time for different stone sizes within 4 weeks study period.

Analysis included 75 patients, in each group, with comparable characteristics. Overall SPR was 56% in GA and 81.3% in GB; achieving significant absolute risk reduction (ARR = 25.3%; p < 0.01) and number needed to treat (NNT) of 3.95. SPR for stones

Tamsulosin therapy for uncomplicated distal ureteral calculi augments SPR, shortens passage time and decrease need for analgesia. Particularly, tamsulosin shortens the passage time for smaller stones, and augments the passage rate for larger stones.