Medical expulsive therapy for ureteral stones

Use of tamsulosin to facilitate passage of ureteral stones 5–10 mm in size. Alpha-blockers relax ureteral smooth muscle and accelerate spontaneous stone passage.

ICD-10 N20.11 drug

Also known as: MET for ureteral stones, Conservative ureteral stone management

Drugs used for this condition

BTamsulosinAdd-on therapy · Alpha-adrenergic blockers for prostatic disordersAdjunctive therapy to facilitate passage of distal ureteral stones 5–10 mm in size. Meta-analyses show tamsulosin accelerates stone passage and reduces analgesic requirements. EAU 2023 guidelines permit tamsulosin 0.4 mg for distal ureteral stones. No proven benefit for stones under 5 mm.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit