Investig Clin Urol.  2016 Sep;57(5):351-356. 10.4111/icu.2016.57.5.351.

Tamsulosin versus tadalafil as a medical expulsive therapy for distal ureteral stones: A prospective randomized study

• KC HB
• Shrestha A
• Acharya GB
• Basnet RB
• Shah AK
• Shrestha P

• KMID: 2427014
• DOI: http://doi.org/10.4111/icu.2016.57.5.351

Abstract

PURPOSE
This study aimed to compare the safety and efficacy of tamsulosin and tadalafil as medical expulsive therapy for distal ureteral stones.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSIONS
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.

Keyword

Tadalafil; Tamsulosin; Ureteral calculi

MeSH Terms

Adolescent
Adult
Aged
Analgesics, Non-Narcotic/administration & dosage
Diclofenac/administration & dosage/analogs & derivatives
Drug Administration Schedule
Female
Humans
Male
Middle Aged
Pain Measurement/methods
Prospective Studies
Renal Colic/etiology
Sulfonamides/administration & dosage/adverse effects/*therapeutic use
Tadalafil/administration & dosage/adverse effects/*therapeutic use
Treatment Outcome
Ureteral Calculi/complications/*drug therapy/pathology
Urological Agents/administration & dosage/adverse effects/*therapeutic use
Young Adult
Analgesics, Non-Narcotic
Sulfonamides
Urological Agents
Tadalafil

Figure

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  Fig. 1 Flow diagram of the study.

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