title: Silodosin vs tamsulosin in the management of distal ureteric stones: A prospective randomised study.
abstract: OBJECTIVE
  To compare the efficacy of silodosin (8 mg) vs tamsulosin (0.4 mg), as a medical expulsive therapy, in the management of distal ureteric stones (DUS) in terms of stone clearance rate and stone expulsion time.
  
  
  METHODS
  A prospective randomised study was conducted on 115 patients, aged 21-55 years, who had unilateral DUS of ⩽10 mm. Patients were divided into two groups. Group 1 received silodosin (8 mg) and Group 2 received tamsulosin (0.4 mg) daily for 1 month. The patients were followed-up by ultrasonography, plain abdominal radiograph of the kidneys, ureters and bladder, and computed tomography (in some cases).
  
  
  RESULTS
  There was a significantly higher stone clearance rate of 83% in Group 1 vs 57% in Group 2 (P = 0.007). Group 1 also showed a significant advantage for stone expulsion time and analgesic use. Four patients, two in each group, discontinued the treatment in first few days due to side-effects (orthostatic hypotension). No severe complications were recorded during the treatment period. Retrograde ejaculation was recorded in nine and three patients in Groups 1 and 2, respectively.
  
  
  CONCLUSIONS
  Our data show that silodosin is more effective than tamsulosin in the management of DUS for stone clearance rates and stone expulsion times. A multicentre study on larger scale is needed to confirm the efficacy and safety of silodosin.
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Hazem
authors.initials: H
authors.lastname: Elgalaly
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sakr
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Fawzi
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Emad A
authors.initials: EA
authors.lastname: Salem
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Esam
authors.initials: E
authors.lastname: Desoky
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Shahin
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Kamel
keywords: DUS, distal ureteric stones; Distal; KUB, plain abdominal radiograph of the kidneys, ureters and bladder; MET, medical expulsive therapy; SWL, shockwave lithotripsy; Silodosin; Stone; Tamsulosin; Ureteric