Does tamsulosin effectively and safely facilitate passage of large, distal ureteric stones?

BEEM Bottom Line

Why is this study important?

Pain from renal colic is a common complaint in the emergency department (ED).[1]Most obstructing ureteral stones do not require immediate surgical intervention; therefore, medications such as Tamsulosin, an alpha-1 receptor blocker, are recommended[2] and believed to hasten stone passage via smooth muscle relaxation at the distal ureter.[3] However, the effectiveness of tamsulosin as medical expulsive therapy (MET) for ureteric calculi remains in question because of conflicting results from meta-analyses of small trials showing benefit compared with the negative findings of large multicenter trials.[4][5][6]

Which, if any, threats to validity are most likely to have an impact on the results and how?

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