A 30-year-old man has a 6 mm smooth calculus impacted at the vesicoureteric junction with well-controlled pain. He has no signs of infection and normal renal function. Which drug has evidence supporting its use to aid spontaneous stone expulsion?
- A Finasteride
- B Atropine
- C Tamsulosin ✓
- D Oxybutynin
Correct answer: C. Tamsulosin
Explanation
Medical expulsive therapy with the alpha-1 blocker tamsulosin relaxes the smooth muscle of the distal ureter and improves spontaneous passage rates for distal ureteric stones up to about 10 mm. Atropine is an antispasmodic with no proven benefit in ureteric colic, finasteride acts on prostatic androgen metabolism, and oxybutynin treats bladder overactivity. Expulsive therapy is inappropriate with fever or infection, where urgent decompression is required instead.
Reference: Smith's General Urology, 19th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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