title: Tadalafil Facilitates the Distal Ureteral Stone Expulsion: A Meta-Analysis.
abstract: To assess the efficacy and safety of tadalafil in facilitating the spontaneous passage of distal ureteral stones.
  
  
  
  The relevant studies were identified by searching MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to November 2016. Randomized controlled trials evaluating effects of tadalafil for distal ureteral stones were included.
  
  
  
  Six publications involving 921 patients were included. Compared with tamsulosin monotherapy, tadalafil monotherapy or combined with tamsulosin has a significantly higher stone expulsion rate (relative risk [RR], 1.16; 95% confidence interval [CI], 1.05 to 1.29; p = 0.004; RR, 1.24; 95% CI, 1.09 to 1.42; p = 0.001, respectively) and shorter time to stone expulsion (mean difference [MD], -1.33 days; 95% CI, -2.44 to -0.23; p = 0.02; MD, -1.98 days; 95% CI, -3.08 to -0.88; p = 0.0004, respectively). Statistically significant differences were noted in pain episodes and analgesic use in favor of group tadalafil alone compared to group tamsulosin alone. The analgesic use was significantly lower in the combined group than in the tamsulosin alone group. Although the occurrence of drug-related adverse events in the tadalafil alone or combined with tamsulosin was higher than that in the use of tamsulosin-alone group, the most common adverse events were mild and tolerable.
  
  
  
  Our study suggested that medical expulsive therapy for the distal ureteral stones using tadalafil alone or combined with tamsulosin is safe, efficacious, and well tolerated.
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Yunjin
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Yubo
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Yin
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Ping
authors.initials: P
authors.lastname: Han
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
mesh_terms: D006801:Humans; D010147:Pain Measurement; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use; D000068581:Tadalafil / Q000008:administration & dosage / Q000627:therapeutic use*; D000077409:Tamsulosin; D014514:Ureteral Calculi / Q000188:drug therapy*; D064804:Urological Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D013449:Sulfonamides; D064804:Urological Agents; D000068581:Tadalafil; D000077409:Tamsulosin
keywords: distal ureteral stone; meta-analysis; randomized controlled trials; tadalafil; tamsulosin