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

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.