Tamsulosin Beneficial for Passage of 5- to 10-mm Distal Ureteral Stones


Am Fam Physician. 2017 Jan 15;95(2):123a-124.

Clinical Question

Is tamsulosin (Flomax) effective in promoting stone passage in patients with distal ureteral stones?

Bottom Line

Tamsulosin promotes stone passage of distal ureteral stones that are 5 to 10 mm in size. You would need to treat five such patients to get one stone passage. Smaller stones tend to pass on their own at a rate of 86% in this study. (Level of Evidence = 1a)


The benefit of tamsulosin for the passage of ureteral stones 10 mm or smaller is uncertain given the conflicting results in recent randomized controlled trials. In this study, investigators searched Medline, Embase, and Central databases, reviewed bibliographies of identified studies, and consulted with experts to find randomized double-blind, placebo-controlled trials that evaluated the effectiveness of tamsulosin on the passage of ureteral stones that were

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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May 1, 2017

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