UroToday- The addition of an anticholinergic medication provides no advantage to alpha-adrenergic receptor blockers alone for ureteral stone passage. In this prospective, randomized study of 120 patients with distal ureteral calculi < 10mm in size the stone expulsion rate was significantly higher in the tamsulosin (0.4mg/day) group, as other researchers have demonstrated. However, the addition of tolterodine (2mg bid) made no significant difference in stone expulsion rates. Nor did tolterodine improve patient pain episodes or visual analog scale pain scores. Therefore, it would appear that relaxation of the ureteral smooth muscle is important for quicker and less painful stone passage but relaxation of the detrusor muscle is of no additional benefit.

Erturhan S, Erbagcı A, Yagcı F, Celik M, Solakhan M, Sarıca K

Urology. 69(4): 633-36, April 2007

doi:10.1016/j.urology.2007.01.009

Reported by UroToday Contributing Editor Elspeth M. McDougall, MD.

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