Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

Imperatore, Vittorio; Fusco, Ferdinando; Creta, Massimiliano; Meo, S. Di; Buonopane, R.; Longo, Nicola; Imbimbo, Ciro; Mirone, Vincenzo

doi:10.4081/aiua.2014.2.103

Cited by 35 publications

(44 citation statements)

References 28 publications

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“…In that era, our results were similar to those of the studies done by Kumar et al [20] and Imperatore et al [21]. Retrograde ejaculation occurred in both groups with no significant difference, as it was reported in 10 (23.3%) and 5 (12.2%) patients in the silodosin and tamsulosin groups, respectively (p = 0.18), but no patients in any group discontinued the medication.…”

Section: Discussionsupporting

confidence: 80%

“…Interestingly Imperatore et al [21] reported a shorter stone expulsion time than ours for both silodosin and tamsulosin groups as it was 7.9 and 7.7 days respectively. Ureterolithiasis causing ureteral colic accounts for up to 2% of the hospital emergency admission [19].…”

Section: Discussionmentioning

confidence: 79%

“…Moreover our results are consistent with those of Kumar et al [20] in which the stone expulsion rate was 83.3 and 64.4% for the silodosin and tamsulosin groups respectively. The difference regarding the stone expulsion rate was insignificant between silodosin (88%) and tamsulosin (84%) in study done by Imperatore et al [21]. The stone expulsion rate diminished dramatically to 52% in the study done by Sur et al [22] who studied the efficacy of silodosin in upper, middle, and lower ureteric stones, and this may be attributed to the fact that alpha 1 a adrenoceptors are more abundant in the lower ureter.…”

Section: Discussionmentioning

confidence: 86%

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

et al. 2018

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Objective: To compare the efficacy and safety of silodosin against tamsulosin as medical expulsion therapeutic agent in stone lower 1/3rd ureter. Patients and Methods: One hundred fifty patients divided equally into 2 groups I and II received silodosin 8 mg and tamsulosin 0.4 mg respectively. Patients aged 18 years or older having single unilateral stone 10 mm or less were included in the study. Patients with bilateral or multiple stones, marked hydronephrosis, previous open or endoscopic surgery and having urinary infection were excluded. Patients were followed weekly for 4 weeks by ultrasonography, plain radiography of the urinary tract and CT of the urinary tract when indicated. Results: Silodosin showed better results against tamsulosin as stone expulsion rate in silodosin and tamsulosin groups was 82.4 and 61.5% respectively with significant difference (p = 0.007). Also, the stone expulsion time was significantly lower in silodosin against tamsulosin groups as it was 9.4 ± 3.8 vs. 12.7 ± 5.1 days in group I and II respectively (p = 0.001). The adverse effects were comparable with non-significant more retrograde ejaculation in the silodosin group. Conclusion: Silodosin showed better efficacy in the stone expulsion rate and time with comparable safety of both drugs, with nonsignificant more retrograde ejaculation in silodosin.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 86%

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

et al. 2018

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“…Our results are in agreement with those of Gupta et al [12] , who reported stone clearance rates of 82% and 58% for their silodosin and tamsulosin groups, respectively; and also in agreement with those of Kumar et al [13] , who reported stone clearance rates of 83.3% and 64.4% for their silodosin and tamsulosin groups, respectively. However, Imperatore et al [14] reported a nonsignificant difference of stone clearance rates between silodosin (88%) and tamsulosin (84%). While Sur et al [15] reported a stone clearance rate of 52%…”

Section: Discussionmentioning

confidence: 99%

Comparative Efficacy of Silodosin vs Tamsulosin for Ureteric Calculus: A Single Centre Double Blind Randomised Controlled Trial

Antony¹

2017

jmscr

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“…(16) Vittorio Imperatore et al, compared for the first time tamsulosin and silodosin in the context of MET for distal ureteric stones. (17) In patients presenting with DUS of 610 mm without the use of MET, the reported spontaneous stone clearance rates are between 35.2% and 61% with mean expulsion times ranging between 9.87 and 24.5 days. (18)(19)(20)(21) Several factors can affect spontaneous stone clearance of DUS including: stone size, site, number and also the presence or absence of ureteric smooth muscle spasm and/or submucosal oedema.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study Comparing Tamsulosin and Silodosin in Medical Expulsive Therapy for Lower Ureteric Stones

Reddy¹,

Prathvi²,

Kulshreshtha³

et al. 2016

jemds

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The urinary stone disease is one of the most common afflictions of the modern society and it has been described since antiquity with the westernization of global culture. The efficacy of mini-invasive therapies, such as Extracorporeal Shock Wave Lithotripsy [ESWL] and ureteroscopy are not risk free, are problematic and are quite expensive. Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitate stone expulsion. MATERIALS AND METHODSThis prospective randomised study was conducted between September 2015 and May 2016 at Rajarajeshwari Medical College and Hospital, Bangalore. The cohort comprised 100 adult patients (54 men and 46 women) who presented with a symptomatic, unilateral, single, uncomplicated lower ureteric stone of ≤ 10 mm. Patients were randomized into two equal groups, 50 (50%) patients received a daily single dose of tamsulosin 0.4 mg for 28 days and 50 (50%) patients received a daily single dose of silodosin 8 mg for 28 days. Both groups were compared in terms of patient's demographics, socioeconomic status, stone size and side, type of MET, stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use and incidence of side effects. Subgroup analysis was performed according to stone size ≤ or > 5 mm. RESULTSNo significant differences among the two groups for patient's age, gender, stone side and stone size. Spontaneous stone expulsion rate within 28 days was observed in 44 (88%) patients in the tamsulosin group and in 45 (90%) patients in the silodosin group without statistically significant differences. There were no statistically significant differences observed in terms of mean expulsion time, mean number of pain episodes and need for analgesics. Retrograde ejaculation was significantly higher in the silodosin arm, while the incidence of side effects related to peripheral vasodilation were higher in the tamsulosin arm, but it was statistically insignificant. CONCLUSIONTamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associated with a lower incidence of side effects related to peripheral vasodilation, but a higher incidence of retrograde ejaculation when compared to tamsulosin. However, a multicentre study on a larger scale is needed to evaluate the current medicines. KEYWORDSTamsulosin, Silodosin, Stone Expulsion Rate, Medical Expulsion Therapy (MET). Financial or Other, Competing Interest: None. Submission 18-06-2016, Peer Review 13-07-2016, Acceptance 18-07-2016, Published 25-07-2016. Corresponding Author: Dr. Sreedhar Reddy, Professor and HOD, Department of Urology Raja Rajeshwari Medical College and Hospital, Bangalore. E-mail: urologyreddy@yahoo.com DOI: 10.14260/jemds/2016 Nevertheless these techniques are not risk free, are problematic and are quite expensive. (4) Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitat...

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Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

Abstract: Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

Cited by 35 publications

References 28 publications

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

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

Comparative Efficacy of Silodosin vs Tamsulosin for Ureteric Calculus: A Single Centre Double Blind Randomised Controlled Trial

A Prospective Study Comparing Tamsulosin and Silodosin in Medical Expulsive Therapy for Lower Ureteric Stones

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