title: Perinatal Outcomes with Tamsulosin Therapy for Symptomatic Urolithiasis.
abstract: OBJECTIVE
  Medical expulsive therapy represents an effective adjunctive treatment for nonpregnant patients with symptomatic urolithiasis. Tamsulosin is classified by the FDA (Food and Drug Administration) as a category B medication. However, to our knowledge no published data exist for human pregnancy. We explored the safety and efficacy of tamsulosin therapy for symptomatic urolithiasis occurring during pregnancy.
  
  
  METHODS
  We retrospectively identified patients treated with tamsulosin for stone disease during pregnancy at the Mayo Clinic during 2000 to 2014. This medical expulsive therapy cohort was matched 2:1 to pregnant women with symptomatic urolithiasis during pregnancy who did not receive medical expulsive therapy. Groups were compared using linear mixed models for continuous variables and exact conditional logistic regression models for nominal variables to take into account correlation due to matching.
  
  
  RESULTS
  A total of 27 patients receiving medical expulsive therapy comprised the study cohort. Median duration of antepartum tamsulosin exposure was 3 days (range 1 to 110), occurring during the first, second and third trimester in 3 (11%), 11 (40.7%) and 18 (67%) patients, respectively. Mean gestational age at delivery was 38.1 weeks (SD 2.4) and 6 (22%) infants were born preterm. All infant birthweights were considered appropriate for gestational age, and no cases of spontaneous abortion, intrauterine demise or neonatal congenital anomalies were encountered. Comparison between the medical expulsive therapy and control groups demonstrated no significant differences in maternal or infant outcomes for any of the examined variables.
  
  
  CONCLUSIONS
  Tamsulosin medical expulsive therapy does not appear to be associated with adverse maternal or fetal outcomes and may be considered as adjunctive therapy for urolithiasis during pregnancy.
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota.
authors.forename: George
authors.initials: G
authors.lastname: Bailey
authors.affiliation: Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Lisa
authors.initials: L
authors.lastname: Vaughan
authors.affiliation: Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Carl
authors.initials: C
authors.lastname: Rose
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota. Electronic address: Krambeck.Amy@mayo.edu.
authors.forename: Amy
authors.initials: A
authors.lastname: Krambeck
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D052878:Urolithiasis / Q000188:drug therapy*; D064804:Urological Agents / Q000627:therapeutic use*
chemical_list: D013449:Sulfonamides; D064804:Urological Agents; D000077409:Tamsulosin
keywords: drug therapy; pregnancy; tamsulosin; urolithiasis