Comparative Study between Silodosin and Tamsulosin in Expectant Therapy of Distal Ureteral Stones

Gharib, Tarek; Mohey, Ahmed; Fathi, Abdallah; Alhefnawy, Mohamed; Alazaby, Hisham; Eldakhakhny, Amr

doi:10.1159/000490623

Cited by 14 publications

(18 citation statements)

References 25 publications

(40 reference statements)

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“…El-Galaly et al [11] reported that the stone expulsion rate in their series on adult patients was significantly higher in the silodosin group in contrast to the tamsulosin group (83 vs. 57%) and this was also associated with a significantly shorter mean expulsion time in the silodosin group (13.3 ± 4.1 vs. 16.7 ± 5.2 days in the silodosin group and tamsulosin group, respectively). Similarly, in another study on adult patients, silodosin showed a statistically significant higher efficacy regarding stone expulsion rate and time versus tamsulosin (82.4 vs. 61.5%) and (9.4 ± 3.8 vs. 12.7 ± 5.1 days), respectively [29]. This is in accordance with our results as we reported a statistically significant better expulsion rate (89.3 vs. 74.5%) and shorter mean expulsion time (12.4 ± 2.3 vs. a Group I has a statistically significant difference versus the other 2 groups (p < 0.05).…”

Section: Discussionmentioning

confidence: 64%

Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

et al. 2021

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Aim: To compare the efficacy and safety of silodosin versus tamsulosin as medical expulsive therapy for stones of lower-third ureter in children. Patients and Methods: This prospective single-blind placebo-controlled randomized study included 167 pediatric patients who presented with distal ureteric stone (DUS) less than 1 cm. Patients were randomized into 3 groups; group I received silodosin 4 mg once daily, and group II received tamsulosin 0.4 mg while those in group III had placebo. The side effects of the used drugs, both rate and time of stone expulsion, and number of pain episodes were compared among the study groups for a maximum of 4 weeks. Results: Follow-up data of our patients after treatment revealed that the stone expulsion rate was significantly higher and the time to stone expulsion was significantly shorter in group I (89.3%, 12.4 ± 2.3 days) and group II (74.5%, 16.2 ± 4.2 days) compared to group III (51.8%, 21.2 ± 5.6). However, a statistically significant difference between silodosin and tamsulosin groups in favor of the former one was reported regarding the 2 studied items. Meanwhile, pain episodes requiring analgesia were statistically fewer in group I and II in contrast to placebo group. Adverse events were comparable among all groups. Conclusion: Silodosin provides significantly better stone expulsion rate and shorter expulsion time than tamsulosin for treatment of DUS. Both medications showed good safety profiles in children. However, further studies are required on a larger scale to confirm our results. Assessment of drug safety on younger age-group is still needed.

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Section: Discussionmentioning

confidence: 64%

Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

et al. 2021

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“…Among 2 RCTs, which compared tamsulosin with silodosin, it was found that silodosin was better in expulsion rate and time. [6,23] but expulsion time contrasted by the studies regulated by Elgalaly H et al and Imperatore V et al [12,24]. The study conducted by Shabana W et al showed that combination therapy of tamsulosin and methylprednisolone is better than monotherapy with tamsulosin.…”

Section: Resultsmentioning

confidence: 98%

An update on efficacy and safety of alpha-blockers in the treatment of distal ureteric stones: narrative review

et al. 2022

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Background Alpha-blockers prescribed as medical expulsion therapy (MET) have replaced minimally invasive procedures as the primary line of treatment for minor ureteric stones. This study aims to investigate the efficacy of MET with alpha-blockers in terms of stone expulsion rate and time and evaluate the safety of several alpha-blockers. Methodology Google Scholar, PubMed, and Web of Science databases were searched for relevant publications using keywords published between December 2013 and August 2021. Additional relevant research was found by looking through the references in the articles. Results To determine the efficacy and safety of alpha-blockers as a medical expulsive therapy for the management of distal ureteral stones, 15 studies were included, 12 randomized control trials, 2 retrospective observational studies, and 1 prospective study. The most commonly studied primary endpoint was stone expulsion rate and time. According to findings, silodosin appears to be more effective than other alpha-blockers. The data revealed no life-threatening adverse effects were associated with alpha-blockers. Conclusion Alpha-blockers are recommended as the first-line therapy for distal ureteral stones. Silodosin was the most efficacious medicine, according to the data. The side effects of alpha-blockers, on the other hand, were minor, consisting primarily of orthostatic hypotension. The alpha-blocker choice differs from urologist to urologist in the management of MET, depending on their experience and the patient's condition.

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“…The drugs used to reduce ureter spasms are calcium antagonists (nifedipine), α1-blockers, and β-adrenergic agonists [7,10,12,22,23].…”

Section: Discussionmentioning

confidence: 99%

Medical Expulsive Therapy for Symptomatic Distal Ureter Stones: Is the Combination of Bromelain and Tamsulosin More Effective than Tamsulosin Alone? Preliminary Results of a Single-Center Study

Palmisano¹,

Spinelli²,

Luzzago³

et al. 2018

Urol Int

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Objectives: To assess the safety and efficacy of bromelain plus tamsulosin versus tamsulosin alone as medical expulsive therapy (MET) for promoting spontaneous stone passage (SSP) of symptomatic distal ureter stones. Patients and Methods: One-hundred-fourteen patients with a 4–10 mm distal ureteral stone were enrolled (Group A). Patients self-administered daily bromelain with tamsulosin for 30 days or until SSP or intervention was mandatory. Patients were compared to those from a control group taking tamsulosin as MET (Group B) and matched for the following factors: sex, age ±10%, stone diameter. A logistic regression model evaluated bromelain and the ureteral stone diameter as explanatory variables. Results: SSP rates were 87.7 vs. 75.4% for group A vs. group B respectively (p = 0.016); with no difference observed for the time to self-reported stone expulsion (11.68 vs. 11.57 days; p = 0.91). Considering larger stones (> 5 mm), the SSP rate was 83.3% in group A and 61% in group B (p < 0.01). With each millimeter increment of stone diameter, the probability of SSP decreased by 59.1% (p < 0.0001), while it increased of 3.3 when bromelain was present. Only 3 cases of tamsulosin-related adverse events were recorded. Conclusion: The association of bromelain and tamsulosin as MET increases the probability of SSP of symptomatic distal ureteral stones, with no bromelain-related side effects recorded.

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Comparative Study between Silodosin and Tamsulosin in Expectant Therapy of Distal Ureteral Stones

Cited by 14 publications

References 25 publications

Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

An update on efficacy and safety of alpha-blockers in the treatment of distal ureteric stones: narrative review

Medical Expulsive Therapy for Symptomatic Distal Ureter Stones: Is the Combination of Bromelain and Tamsulosin More Effective than Tamsulosin Alone? Preliminary Results of a Single-Center Study

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