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Distal ureteric stones and tamsulosin: A double-blind, placebo-controlled, randomized, multicenter trial
Annals of Emergency Medicine
  • Jeremy Furyk, The Townsville Hospital, Townsville, Queensland, Australia
  • Kevin Chu, University of Queensland
  • Colin Banks, Townsville, Queensland, Australia
  • Jaimi Greenslade, Royal Brisbane & Women's Hosp, Brisbane,
  • Gerben Keijzers, Bond University
  • Ogilvie Thom, University of Queensland
  • Tom Torpie, Bond University
  • Carl Dux, Princess Alexandra Hospital
  • Rajan Narula, James Cook University Australia
Date of this Version
1-1-2016
Document Type
Journal Article
Publication Details

Published version

Furyk, J. S., Chu, K., Banks, C., Greenslade, J., Keijzers, G., Thom, O., Torpie, T., Dux, C., & Narula, R. (2016). Distal ureteric stones and tamsulosin: A double-blind, placebo-controlled, randomized, multicenter trial. Annals of Emergency Medicine, 67(1), 86-95.

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© 2015 American College of Emergency Physicians. Published by Elsevier Inc.

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0
Abstract
Study objective: We assess the efficacy and safety of tamsulosin compared with placebo as medical expulsive therapy in patients with distal ureteric stones less than or equal to 10 mm in diameter. Methods: This was a randomized, double-blind, placebo-controlled, multicenter trial of adult participants with calculus on computed tomography (CT). Patients were allocated to 0.4 mg of tamsulosin or placebo daily for 28 days. The primary outcomes were stone expulsion on CT at 28 days and time to stone expulsion. Results: There were 403 patients randomized, 81.4% were men, and the median age was 46 years. The median stone size was 4.0 mm in the tamsulosin group and 3.7 mm in the placebo group. Of 316 patients who received CT at 28 days, stone passage occurred in 140 of 161 (87.0%) in the tamsulosin group and 127 of 155 (81.9%) with placebo, a difference of 5.0% (95% confidence interval -3.0% to 13.0%). In a prespecified subgroup analysis of large stones (5 to 10 mm), 30 of 36 (83.3%) tamsulosin participants had stone passage compared with 25 of 41 (61.0%) with placebo, a difference of 22.4% (95% confidence interval 3.1% to 41.6%) and number needed to treat of 4.5. There was no difference in urologic interventions, time to self-reported stone passage, pain, or analgesia requirements. Adverse events were generally mild and did not differ between groups. Conclusion: We found no benefit overall of 0.4 mg of tamsulosin daily for patients with distal ureteric calculi less than or equal to 10 mm in terms of spontaneous passage, time to stone passage, pain, or analgesia requirements. In the subgroup with large stones (5 to 10 mm), tamsulosin did increase passage and should be considered.
Citation Information
Jeremy Furyk, Kevin Chu, Colin Banks, Jaimi Greenslade, et al.. "Distal ureteric stones and tamsulosin: A double-blind, placebo-controlled, randomized, multicenter trial" Annals of Emergency Medicine Vol. 67 Iss. 1 (2016) p. 86 - 95 ISSN: 0196-0644
Available at: http://works.bepress.com/gerben_keijzers/30/