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This prospective, randomized controlled study was conducted on 162 patients with ureteral stones; 9 patients were excluded due to loss to follow-up, and the remaining 153 patients were divided into three groups. Group I (control) included 51 patients who received a placebo. Group II included 51 patients who received 1000\u00a0mg of L-arginine once daily. Group III included 51 patients who received tamsulosin 0.4\u00a0mg once daily. There was a highly statistically significant difference between the studied groups regarding ultrasound (U\/S) and plain urinary tract (PUT) findings after 4 weeks. Spontaneous stone expulsion rates (SER) in the control, L-arginine, and tamsulosin groups were 6 (11.8%), 48 (94.1%), and 16 (31.4%), respectively (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). The mean\u2009\u00b1\u2009SD of stone expulsion time in the control, L-arginine, and tamsulosin groups was 19.6\u2009\u00b1\u20095.85, 19.02\u2009\u00b1\u20095, and 20.58\u2009\u00b1\u20095.78 days, respectively (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). There was no statistically significant difference between the groups regarding the number of daily colic episodes and total analgesic dosage required. However, a statistically significant difference was noted regarding stone density and hydronephrosis. It is concluded that L-arginine is more effective than tamsulosin in increasing the SER and reducing stone expulsion time, with better pain control, making it a safe and effective MET for ureteral stones.\n                  <\/jats:p>","DOI":"10.1007\/s00240-025-01768-3","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T09:36:27Z","timestamp":1749634587000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["L-arginine role for stone lower ureter: A randomized controlled trial"],"prefix":"10.1007","volume":"53","author":[{"given":"Ahmed","family":"Mahmoud Mohammed Ahmed Elsherief","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Mahmoud Riyad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Abdellah Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr","family":"Alam-Eldin Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Ali Gad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Mamdouh Abd elhameid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"issue":"1","key":"1768_CR1","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.euf.2017.04.001","volume":"1","author":"OA Raheem","year":"2017","unstructured":"Raheem OA, Khandwala YS, Sur RL, Ghani KR, Denstedt JD (2017) Burden of urolithiasis: trends in prevalence, treatments, and costs. 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