Seven RCTs (n=2,455) were included in the review. None of the included studies reported the method of randomisation or allocation concealment, but all were double-blinded and reported the number of patients who withdrew. All studies scored 3 for study quality.
Differences in pooled symptom scores (SMD -1.17, 95% CI -1.50 to -0.84; five RCTs) and maximum flow rate (WMD 1.02, 95% CI 0.71 to 1.34; five RCTs) favoured tamsulosin in comparison with placebo (figures in the text and forest plot differed; these were from the forest plot). Only one RCT assessed quality of life and this did not report a significant difference between tamsulosin and placebo. There was no evidence of statistical heterogeneity for any analyses. There was no significant difference in the incidence of adverse events between tamsulosin and placebo (three RCTs). Reported events included fatigue, pharyngitis, dizziness, rhinitis, postural hypotension, headache and abnormal erection.
A funnel plot of symptom scores suggested that there was a risk of publication bias.