In this issue of JAMA Internal Medicine, Meltzer and colleagues1 report the results of a randomized clinical trial assessing the role of an α-blocker, tamsulosin, among patients presenting to the emergency department with renal colic secondary to a ureteral stone. In the absence of indications for immediate intervention (eg, pyelonephritis, obstruction of a solitary kidney, intractable pain), a trial of conservative treatment is warranted in this population, given that many patients will pass their stones spontaneously. However, since a number will fail conservative treatment and require a procedure for stone removal, there is great interest in strategies for increasing the likelihood of stone passage. The use of α-blockers like tamsulosin and calcium channel blockers, commonly referred to as medical expulsive therapy, has been championed as one such strategy.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Dahm P, Hollingsworth JM. Medical Expulsive Therapy for Ureteral Stones—Stone Age Medicine. JAMA Intern Med. Published online June 18, 2018. doi:10.1001/jamainternmed.2018.2265
Customize your JAMA Network experience by selecting one or more topics from the list below.