Objective: To review the evidence for tamsulosin as medical expulsive therapy in enhancing the effectiveness of distal ureteral stone clearance rate. Methods: We searched Pubmed/Medline

Embase

CBM and the Cochrane Library up to October 2011. All randomized controlled trials in which tamsulosin was evaluated with distal ureterolithiasis were eligible for the analysis. Outcome measure assessed was stone clearance rate. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5.1. Results: Thirteen studies involving 1067 participants met the inclusion criteria. Study duration ranged from 7 to 42 d. The pooled analysis showed an improvement of 41% in stone clearance rate of tamsulosin as medical expulsive therapy for distal ureteral calculi （RR=1.41

95% CI=1.18 to 1.70）. According to stone size （6 mm<size<10 mm

5 mm<size<6 mm

size <5 mm）

the pooling effects of tamsulosin were analyzed

with a higher stone expulsion rate obtained than control （RR=1.52

1.75

1.05

95% CI=1.30 to 1.77

1.25 to 2.45

0.95 to 1.16

respectively）. Adverse effects of tamsulosin

mainly retrograde ejaculation

dizziness and hypotension

were reported in 7 included trials. Conclusion: Treatment with tamsulosin appears to be a safe and effective medical expulsion therapy for distal ureterolithiasis. To make a definite clinical recommendation to use tamsulosin as medical expulsive treatment for distal ureteral calculi

high quality multicentric

randomized

double blinded

controlled trials are necessary to prove its efficacy.