We read with interest the article by Ye et al  showing that tamsulosin therapy for stones in the distal ureter (DU) resulted in a higher spontaneous stone passage (SSP) than placebo (difference 7.8%, 95% confidence interval 5.2–10.4%), with a particular benefit for stones of 5–7 mm in size, with similar rates of adverse events in both arms. While meta-analyses of primarily small randomized trials showed a benefit of tamsulosin versus placebo , this was thrown into doubt when large, well-designed, randomized studies did not show this benefit , . Differences in study design could explain the contrasting results from the published studies.
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Shah, T. T., MacLennan, G., Pickard, R., McClinton, S., & Kasivisvanathan, V. (2018). Letter to the Editior. Re Zhangqun Ye, Guohua Zeng, Huan Yang, et al. Efficacy and Safety of Tamsulosin in Medical Expulsive Therapy for Distal Ureteral Stones with Renal Colic: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial. Eur Urol 2018;73:385–91: Medical Expulsive Therapy for Distal Ureteral Stones: Call the Jury Back. European Urology, 74(2), e43-e44. https://doi.org/10.1016/j.eururo.2018.03.004