A 35-year-old man has a 5 mm smooth radio-opaque calculus at the vesicoureteric junction causing renal colic, controlled with analgesics. He has no fever, no infection and a solitary normal kidney. Along with analgesia, which drug improves the rate of spontaneous stone passage?
- A Tamsulosin ✓
- B Oxybutynin
- C Finasteride
- D Sildenafil
Correct answer: A. Tamsulosin
Explanation
Medical expulsive therapy with the alpha-1 blocker tamsulosin relaxes smooth muscle in the distal ureter and increases spontaneous passage rates for small (less than about 10 mm) distal ureteric stones. Stones up to 5 mm generally pass spontaneously even without it, but tamsulosin shortens the time to passage. Oxybutynin treats bladder overactivity, finasteride acts on prostatic androgen metabolism, and sildenafil has no role in stone disease. Fever or infection would instead mandate urgent decompression by stent or nephrostomy.
Reference: Smith's General Urology, 19th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.