Alpha Blockers to Speed Ureteral Stone Passage

(Strength of Recommendation: A, based on consistent, good-quality patient-oriented evidence.) Practice Pointers The prevalence of kidney stone disease has increased in recent years and affects 5% to 10% of the population.1 Alpha blockers relax smooth muscle and decrease intraureteral pressures. Exclusion criteria included urinary tract infection, hydronephrosis, or other underlying abnormalities of the kidney or ureters. When looking at stone-free status by the end of the study, patients taking alpha blockers had much improved clearance compared with those in standard therapy (30 studies with 2,378 participants; relative risk [RR] = 1.48; number needed to treat [NNT] = 4), and also when compared head-to-head with patients taking calcium channel blockers (four studies with 3,486 participants; RR = 1.19; NNT = 4.8).