Alpha-blocker may have benefit in larger stones
While there is no benefit from using tamsulosin (Flomax) versus placebo for the treatment of small ureteral stones, there is a potential upside of increased passage from using the drug to treat 5- to 10-mm stones, according to a study from Australia published online in the Annals of Emergency Medicine (July 13, 2015).
First author Jeremy Furyk, MBBS, MPH, of Townsville Hospital, Townsville, Queensland, and colleagues studied 403 patients randomized to receive 0.4 mg of tamsulosin or placebo daily, for 28 days. Median stone size was 4.0 mm in the tamsulosin group versus 3.7 mm in the placebo group.
They found no significant difference between the groups within 28 days of patients’ visits to the emergency department. Eighty-seven percent of those in the tamsulosin group and 81.9% of patients in the placebo group passed their stones. But in a subgroup analysis of large stones—5 to 10 mm—83.3% of tamsulosin participants had stone passage versus 61.0% of those receiving placebo.
Otherwise, the authors found no differences in urologic interventions, time to self-reported stone passage, pain, analgesia needs, or adverse events, according to the study’s abstract.
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