Efficacy of tamsulosin versus tadalafil as medical expulsive therapy on stone expulsion in patients with distal ureteral stones: A randomized double-blind clinical trial

Falahatkar, Siavash; Akhavan, Ardalan; Esmaeili, Samaneh; Amin, Atiyeh; Kazemnezhad, Ehsan; Jafari, Alireza

doi:10.1590/s1677-5538.ibju.2020.1007

Cited by 9 publications

(11 citation statements)

References 23 publications

(39 reference statements)

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“…Four RCTs that compared tamsulosin with placebo or any other drug except alpha-blockers showed that tamsulosin had a better expulsion rate and time. [3,[17][18][19]. But studies conducted by Puvvada S et al and Kc HB et al showed that tadalafil was better when compared to tamsulosin in terms of expulsion rate and time taken for stone expulsion [20,21].…”

Section: Resultsmentioning

confidence: 99%

“…No serious adverse effects were associated with the use of alpha-blockers. Most commonly reported adverse effects included orthostatic hypotension, palpitation, headache, dizziness, backache, abnormal ejaculation, retrograde ejaculation, gastritis, fatigue, nasal congestion, constipation, nausea, diarrhoea, asthenia, increased erection, dry mouth, flushing, muscle cramps, dyspepsia, sexual dysfunction, collapse, vomiting, and hearing problem [2,3,5,6,8,10,12,[17][18][19][20][21][22][23][24]. The detailed results are described in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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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“…Recently have begun to appear the data on the effectiveness of Tadalafil alone and its combination with Tamsulosin on renal calculus clearance after shock wave lithotripsy [ 15 ]. Efficacy of tamsulosin versus tadalafil as medical expulsive therapy on stone expulsion in patients with distal ureteral stones is studying [ 16 ]. Researchers suggested that Tadalafil can dilate ureters promoting the passage of ureteral calculus.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of combination therapy Tadalafil plus Tamsulosin in ureteral stents-related symptoms relief

2023

Cent European J Urol

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Introduction Ureteral stents-related symptoms (USRs) are the common complications of ureteral stenting. Tamsulosin a selective alpha-1 blocker and Tadalafil a PDE-5 inhibitor are one of drugs have been used for USRs relief. In this study we aimed to evaluate the effectiveness and safety of combination therapy Tamsulosin+Tadalafil for treating USRs comparing it with the efficacy of either Tamsulosin or Tadalafil monotherapies. Material and methods 279 patients with indwelled unilateral ureteral stents were randomized to Tamsulosin 0.4 mg + Tadalafil 5 mg once a day (Group 1, n = 67), Tamsulosin 0.4 mg once a day (Group 2, n = 71), Tadalafil 5 mg once a day (Group 3, n = 69) and Placebo once a day (Group 4, n = 72). USRs severity was registered and calculated by using the Ureteral Symptoms Score Questionnaire (USSQ) at the 14 th day of treatment. Side-effects and total analgesic use were recorded and compared. Results At the endpoint in patients with unilateral ureteral stents the combination therapy Tamsulosin + Tadalafil led to statistically lower intensity of urinary symptoms comparing with Tamsulosin (15.2 ±4.3 vs 21.8±3.6, p = 0.0003) or Tadalafil (15.2 ±4.3 vs 20.6 ±2.8, p = 0.0004) monotherapy. All groups of treatment demonstrated significant relief of USRs comparing with Placebo mostly beneficial in the combined therapy group. Body pain and analgesic need in Group 1 was lower than in Groups 2, 3 or 4. Side-effects were registered rarely without statistical differences in frequency between groups. Conclusions Combination therapy with Tamsulosin + Tadalafil is an effective and safe option that achieves the statistically more significant relief of USRs comparing with Tadalafil or Tamsulosin monotherapies.

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“…Silodosin has a higher affinity for alpha-1A receptors than tamsulosin, leading to greater selectivity and fewer side effects. Several studies have investigated the efficacy and safety of silodosin in the treatment of ureteral stones and have shown promising results [4]. One metaanalysis of 14 randomized controlled trials involving 1,928 patients compared the efficacy and safety of tamsulosin and silodosin in MET for lower ureteral calculi.…”

Section: Introductionmentioning

confidence: 99%

Can Silodosin Be Considered a Superior Substitute for Tamsulosin in Medical Expulsion Therapy for Patients with Lower Ureteral Calculi

Ahmed¹,

Rizvi²,

Riaz³

et al. 2023

PJMHS

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Introduction: Urinary stones, also known as calculi, are a common urological problem affecting millions of people worldwide. Medical expulsion therapy (MET) is a commonly used treatment for lower ureteral calculi. Objectives: The main objective of the study is to find the role of silodosin as a superior substitute for tamsulosin in medical expulsion therapy for patients with lower ureteral calculi. Material and methods: The study design for this research article would be a randomized controlled trial comparing the efficacy and safety of silodosin and tamsulosin in medical expulsion therapy (MET) for patients with lower ureteral calculi. Patients with lower ureteral calculi who meet the inclusion criteria will be recruited for the study. Inclusion criteria may include age over 18 years, presence of lower ureteral calculus confirmed by imaging, and willingness to participate in the study. Exclusion criteria may include previous history of ureteral surgery, contraindication to alpha-blockers, and pregnancy. Results: A total of 100 participants were randomized to receive either silodosin (n=50) or tamsulosin (n=50) for medical expulsion therapy of lower ureteral calculi. The mean age of the participants was 45 years, and 60% were male. The stone expulsion rate at 4 weeks was 80% in the silodosin group and 75% in the tamsulosin group. There was no statistically significant difference between the two groups (p=0.54). Conclusion: In conclusion, the results of this study indicate that silodosin may not be a superior substitute for tamsulosin in medical expulsion therapy for patients with lower ureteral calculi. Both drugs demonstrated similar rates of stone expulsion and time to stone passage, as well as comparable safety profiles and patient satisfaction rates. Keywords: Silodosin, Tamsulosin, Lower Ureteral Calculi

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Efficacy of tamsulosin versus tadalafil as medical expulsive therapy on stone expulsion in patients with distal ureteral stones: A randomized double-blind clinical trial

Cited by 9 publications

References 23 publications

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

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

Efficacy of combination therapy Tadalafil plus Tamsulosin in ureteral stents-related symptoms relief

Can Silodosin Be Considered a Superior Substitute for Tamsulosin in Medical Expulsion Therapy for Patients with Lower Ureteral Calculi

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