title: Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin.
abstract: OBJECTIVE
  To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET) of distal ureteric stones.
  
  
  METHODS
  Observational data were collected retrospectively from patients who received silodosin (N = 50) or tamsulosin (N = 50) as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared.
  
  
  RESULTS
  Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant). Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant). Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant). The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant). Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups.
  
  
  CONCLUSIONS
  Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.
authors.affiliation: Department of Urology, Buon Consiglio Fatebenefratelli Hospital, Naples. max.creta@gmail.com.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Imperatore
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Fusco
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Creta
authors.forename: Sergio
authors.initials: S
authors.lastname: Di Meo
authors.forename: Roberto
authors.initials: R
authors.lastname: Buonopane
authors.forename: Nicola
authors.initials: N
authors.lastname: Longo
authors.forename: Ciro
authors.initials: C
authors.lastname: Imbimbo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D014514:Ureteral Calculi / Q000628:therapy*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D007211:Indoles; D013449:Sulfonamides; C095285:silodosin; D000077409:Tamsulosin