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

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 10 mm or smaller. Preplanned subgroup analyses showed that tamsulosin was more effective than placebo for 5- to 10-mm distal stones (79% vs. 57%; risk difference = 22%; 95% confidence interval, 12% to 33%; number needed to treat = 5), but not for those smaller than 5 mm. Because smaller stones are likely to pass spontaneously, treatment would not necessarily add any benefit. [...]although there was evidence of publication bias, the authors did a thorough job of searching for possible unpublished reports and did not find any of high quality.