Alpha-blockers have been used as medical expulsive therapy for ureteric stones for a number of years. Conventional wisdom supporting their use has recently been challenged by the publication of a large, multi-centre, randomised double-blinded, placebo-controlled study, SUSPEND, which showed that they were ineffective. This paper looks at the evidence behind the use of alpha-blockers, and discusses why we should believe the evidence we have from SUSPEND, rather than other published studies, and therefore stop using them as medical expulsive therapy.
Keywords: Alpha-blocker; Colic; Tamsulosin; Ureteric stone; Urolithiasis.
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