International Journal of Urology (2005) 12, 615–620 Blackwell Science, LtdOxford, UKIJUInternational Journal of Urology0919-81722005 Blackwell Publishing Asia Pty LtdJuly 2005127615620Original Article Effect of tamsulosin on lower ureteral calculusS Resim et al. Correspondence: Sefa Resim MD, P.K. 157, 46002, Kahra- manmaras, Turkey. Email: safaresim@ksu.edu.tr Received 26 February 2004; accepted 27 December 2004. Original Article Effect of tamsulosin on the number and intensity of ureteral colic in patients with lower ureteral calculus SEFA RESIM, 1 HASAN EKERBICER 2 AND AHMET CIFTCI 1 1 Department of Urology, KSU Medical School and 2 Department of Public Health, KSU Medical School, Kahramanmaras, Turkey Abstract Background: We aimed to objectively determine whether tamsulosin as an a 1 -blocker was effective in patients who had ureterolithiasis located in the lower part of the ureter. Methods: Sixty patients with lower ureteral calculi (juxtavesical or intramural portion) were included in the present study. Conservative treatment, such as hydration and tenoxicam as a non-steroidal anti-inflammatory drug, was given to group 1 (30 patients). Group 2 (30 patients) was given tamsulosin (0.4 mg daily) in addition to the conservative treatment. All patients were followed up and questioned about the numbers and intensity of ureteral colic, and the rates of spontaneous passage after the procedure. Results: Spontaneous passage was observed in 22 of the 30 patients in group 1 (73.3%) and 26 of the 30 patients in group 2 (86.6%). The difference within groups 1 and 2 was not significant (P = 0.196). The difference between both groups was not statistically significant either, with the stone diameter being 6 mm (P = 0.635) or >6 mm (P = 0.407). As group 1 patients were passing their stones, they had more ureteral colic episodes than group 2 patients. This difference was statistically significant and correlated well with the administration of tamsulosin (P = 0.038). Group 1 patients reported higher scores according to a visual analog scale than group 2 patients. Also, this difference was statistically significant (P = 0.000). Conclusions: We think that the treatment of a 1 -blockers decreased the number of ureteral colic episodes and the intensity of pain during spontaneous passage at the lower ureteral calculi. Also, it will be beneficial to patients’ quality of life. Key words a 1 -blocker, lower ureteral stone, tamsulosin, ureteral colic, visual analog scale. Introduction Ureteral stones occupy an important place in daily uro- logical practice, usually causing an acute episode of ureteral colic by obstructing the urinary tract. Most of these calculi are usually impacted in the lower portion of the ureter. 1,2 Ureteral calculi located at the distal ureter have a 50% chance of spontaneous passage with only conservative observation. 1,2 However, this approach can result in complications, such as infection of the urinary tract, hydronephrosis and persistent pain. Therefore, it is difficult to choose between interven- tional therapies (extracorporeal shock wave lithotripsy or ureteroscopy) and a conservative approach, espe- cially when patients have small stones and/or few symptoms. Although a 1 -blockers are routinely used in the treat- ment of lower urinary tract symptoms, some studies suggest that a 1 -blockers inhibit basal tone, peristaltic frequency and ureteral contractions in the ureter. 3–5 But, there has not been sufficient clinical study relevant to this aim. For this reason, we investigated whether tam- sulosin, as an a 1 -blocker agent increasing the passage of stone, has a beneficial effect on the spontaneous passage of stones by relaxing the ureteral smooth muscles.