A comparison of tamsulosin and silodosin versus tadalafil in medical
expulsive therapy for distal ureteral stone in men: a prospective study
Abstract
Objectives: To evaluate the efficacy of tamsulosin, silodosin, and
tadalafil as medical expulsive therapy for distal ureteral stones in
men. Methods: Adult males meeting the inclusion criteria were randomized
into one of four treatment arms - dexketoprofen (control group),
tamsulosin (Group 1), silodosin (Group 2), and tadalafil (Group 3). The
stone expulsion rate after four weeks represented the primary endpoint,
while the stone expulsion rate at the end of the study and the incidence
of adverse events constituted secondary endpoints. Clinical findings
were compared between all four drug groups. Results: No statistically
significant difference was observed among the groups in terms of age,
body mass index, stone futures, expulsion time, pain episodes, or total
analgesic use. Expulsion rates in the fourth week were 42.5%, 80%,
82.5%, and 75%, respectively. The stone expulsion rates in groups 1,
2, and 3 were significantly higher than in the control group (p
< 0.001). However, the differences between groups 1, 2, and 3
were not statistically significant. No serious adverse effects were
observed during the study period. Conclusion: The study results showed a
higher expulsion rate in male patients using tamsulosin, silodosin and
tadalafil for distal ureteral stones, but no significant superiority
between these. All three are safe, effective, and well-tolerated,
causing minimal side-effects.