Tamsulosin versus tadalafil as a medical expulsive therapy for distal ureteral stones: A prospective randomized study.
This study aimed to compare the safety and efficacy of tamsulosin and tadalafil as medical expulsive therapy for distal ureteral stones.



This prospective randomized study was conducted at the Department of Urology of Bir Hospital over a period of 12 months in patients with distal ureteral stones sized 5 to 10 mm. Patients were randomly divided into 2 groups: group A received tamsulosin 0.4 mg and group B received tadalafil 10 mg at bedtime for 2 weeks. Stone expulsion rate, number of ureteric colic episodes and pain score, analgesic requirements, and adverse drug effects were noted in both groups. Statistical analyses were performed by using Student t-test and chi-square test.



Altogether 85 patients, 41 in group A and 44 in group B, were enrolled in the study. The patients' average age was 31.72±12.63 years, and the male-to-female ratio was 1.5:1. Demographic profiles, stone size, and baseline investigations were comparable between the 2 groups. The stone expulsion rate was significantly higher in the tadalafil group than in the tamsulosin group (84.1% vs. 61.0%, p=0.017). Although the occurrence of side effects was higher with tadalafil, this difference was not significant (p=0.099). There were no serious adverse effects.



Tadalafil has a significantly higher stone expulsion rate than tamsulosin when used as a medical expulsive therapy for distal ureteral stones sized 5-10 mm. Both drugs are safe, effective, and well tolerated with minor side effects.
Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Hari Bahadur
HB
Kc
Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Anil
A
Shrestha
Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Ganesh Bhakta
GB
Acharya
Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Robin Bahadur
RB
Basnet
Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Arvind Kumar
AK
Shah
Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Parash Mani
PM
Shrestha
D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D004008:Diclofenac / Q000008:administration & dosage / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D056844:Renal Colic / Q000209:etiology; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000068581:Tadalafil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D064804:Urological Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
D018712:Analgesics, Non-Narcotic; D013449:Sulfonamides; D064804:Urological Agents; D004008:Diclofenac; D000068581:Tadalafil; D000077409:Tamsulosin; C056498:aceclofenac
Tadalafil; Tamsulosin; Ureteral calculi