[Tamsulosin efficacy and safety for conservative management of renal colic: systematic review and meta-analysis of randomized controlled trials]

Abstract

Background and objective: The aim is to evaluate tamsulosin efficacy and safety on the expulsion of distal ureteral stones compared to a standard therapy.

Material and methods: Systematic searches were conducted on PubMed, SCOPUS and The Cochrane Library so as to identify randomized and controlled clinical trials in patients treated with tamsulosin with ureteral stone expulsion and adverse events published until 2014 December, without language restriction. Treatment effect was calculated along with the 95% confidence interval (95% CI), using the variance inverse method for random effects. Heterogeneity was determined by I(2). Publication bias was assessed by Egger test.

Results: The search identified 480 articles. Thirty-eight met the selection criteria, a total of 3,107 patients. The relative risk (RR) of expulsion was 1.53 (95% CI 1.38-1.69; I(2)=71%.), while the RR of adverse effects was 1.79 (95% CI 1.19-2,71; I(2)=0).

Conclusions: Tamsulosin treatment seems to bring on the expulsion of distal ureteral stones, although at the expense of an appreciable risk of side effects.

Keywords: Efectos adversos; Expulsion rate; Litiasis renal; Side effects; Tamsulosin; Tamsulosina; Tasa de expulsión; Urolithiasis.