title: Prospective randomized trial comparing efficacy of alfuzosin and tamsulosin in management of lower ureteral stones.
abstract: OBJECTIVE
  To study the efficacy of alfuzosin compared with tamsulosin in the management of lower ureteral stones.
  
  
  METHODS
  A total of 102 patients with stones <1 cm size and located in the lower ureter were enrolled in the present study and randomized into 3 equal groups. Group 1 patients (n = 34) received 0.4 mg tamsulosin daily, group 2 patients (n = 34) received 10 mg alfuzosin daily, and group 3 patients (n = 34) received placebo (control group). The patients were given 75 mg diclofenac injection intramuscularly on demand and were followed up for 4 weeks.
  
  
  RESULTS
  The average stone size for groups 1, 2, and 3 was comparable (6.17, 6.70, and 6.35 mm, respectively). Stone expulsion was observed in 28 of 34 patients (82.3%) in group 1, 24 of 34 patients (70.5%) in group 2, and 12 of 34 patients (35.2%) in group 3. The average expulsion time for groups 1, 2, and 3 was 12.3, 14.5, and 24.5 days, respectively. The results of both study groups (groups 1 and 2) were superior to those in the placebo group (P = .003 and P = .001, respectively), but the study failed to show any statistically significant differences between tamsulosin and alfuzosin (P = .25). Alfuzosin was associated with fewer side effects than tamsulosin, especially in terms of retrograde ejaculation.
  
  
  CONCLUSIONS
  Medical treatment of lower ureteral calculi with tamsulosin and alfuzosin resulted in a significantly increased stone expulsion rate, decreased expulsion time, and a reduced need for analgesic therapy.
authors.affiliation: Division of Urology, Department of Surgery, S N Medical College, Agra, India. dr.madhu.agra@gmail.com
authors.forename: Madhusudan
authors.initials: M
authors.lastname: Agrawal
authors.forename: Manoj
authors.initials: M
authors.lastname: Gupta
authors.forename: Apurva
authors.initials: A
authors.lastname: Gupta
authors.forename: Akash
authors.initials: A
authors.lastname: Agrawal
authors.forename: Avijit
authors.initials: A
authors.lastname: Sarkari
authors.forename: Prashant
authors.initials: P
authors.lastname: Lavania
mesh_terms: D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011799:Quinazolines / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D014514:Ureteral Calculi / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000317:Adrenergic alpha-Antagonists; D011799:Quinazolines; D013449:Sulfonamides; C047638:alfuzosin; D000077409:Tamsulosin