Meta-analysis: tamsulosin eases passage of ureteral stones

  • Sun Y & al.
  • Medicine (Baltimore)
  • 1 Mar 2019

  • International Clinical Digest
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Takeaway

  • Tamsulosin (Flomax) significantly facilitates passage of distal ureteral stones, without increasing the rate of side effects.

Why this matters

  • Providers should “strongly recommend” tamsulosin to patients with ureteral stones to increase treatment efficacy, say researchers.

Study design

  • Researchers analyzed 49 studies comparing tamsulosin with control treatments (n=6436).
  • Funding: National Natural Science Foundation of China; National Key Research and Development Program of China; Prostate Cancer Foundation; Foundation of Science & Technology Department of Sichuan Province; Sichuan University; Health Department of Sichuan Province.

Key results

  • Treatment with tamsulosin:
    • Improved renal stone clearance rates:
      • 80.5% vs 70.5%;
      • mean difference (MD), 1.16 (95% CI, 1.13-1.19; P<.00001>
    • Reduced expulsion time:
      • MD, −3.61 (95% CI, −3.77 to −3.46; P≤.00001).
  • There was no significant difference in total side effects between tamsulosin and control groups:
    • MD, 1.15 (95% CI, 0.97-1.35; P=.10).

Limitations

  • Control treatments were different across studies, including placebo, watchful waiting, and additional water intake.
  • The analysis did not compare tamsulosin with other α-blockers or medicines.

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