Perinatal Outcomes with Tamsulosin Therapy for Symptomatic Urolithiasis

Area of Science:

• Urology
• Maternal-Fetal Medicine
• Pharmacology

Background:

• Medical expulsive therapy (MET) is effective for symptomatic urolithiasis in nonpregnant patients.
• Tamsulosin, an FDA category B medication, lacks published safety data in human pregnancy.
• Symptomatic urolithiasis during pregnancy presents a clinical challenge regarding treatment safety.

Purpose of the Study:

• To explore the safety and efficacy of tamsulosin as MET for symptomatic urolithiasis during pregnancy.
• To evaluate maternal and infant outcomes in pregnant patients receiving tamsulosin for kidney stones.

Main Methods:

• Retrospective cohort study of pregnant patients treated with tamsulosin for urolithiasis (2000-2014).
• Matched 2:1 with a control group of pregnant patients with urolithiasis who did not receive MET.
• Statistical analysis using mixed models and conditional logistic regression to account for matching.

Main Results:

• 27 patients received tamsulosin, with exposure across all trimesters.
• No significant differences in maternal or infant outcomes (preterm birth, birthweight, congenital anomalies) between MET and control groups.
• All infant birthweights were appropriate for gestational age; no spontaneous abortions or intrauterine demise observed.

Conclusions:

• Tamsulosin MET appears safe and is not associated with adverse maternal or fetal outcomes in pregnancy.
• Tamsulosin may be considered as an adjunctive treatment option for pregnant patients with urolithiasis.
• Further research can confirm the long-term safety and efficacy of tamsulosin in pregnancy.