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. 2024 May 30:15:1351312.
doi: 10.3389/fphar.2024.1351312. eCollection 2024.

Pooled-analysis of tadalafil and tamsulosin for ureteral calculi

Fengze Sun #  1 , Hongquan Liu #  1 , Gang Wu #  1 , Ming Liu  2 , Shangjing Liu  1 , Lin Wang  1 , Qingsong Zou  1 , Yuanshan Cui  1 , Jitao Wu  1
Affiliations

Pooled-analysis of tadalafil and tamsulosin for ureteral calculi

Fengze Sun et al. Front Pharmacol. .

Abstract

Objective: Urolithiasis is a common urological diseases and affects the daily life of patients. Medical expulsive therapy has become acceptable for many parents. We conducted a meta-analysis to determine the efficacy and safety of tadalafil compared with tamsulosin for treating distal ureteral stones less than 10 mm in length.

Methods: Related studies were identified via searches of the PubMed, Embase, and Cochrane Library databases. All the articles that described the use of tadalafil and tamsulosin for treating distal ureteral stones were collected.

Results: A total of 14 studies were included in our meta-analysis. Our results revealed that tadalafil enhanced expulsion rate [odds ratio (OR) = 0.68, 95% confidence interval (CI): 0.47 to 0.98, p = 0.04]; reduced expulsion time [mean difference (MD) = 1.22, 95% CI (0.13, 2.30), p = 0.03]; lowered analgesia use [MD = 38.66, 95% CI (7.56, 69.77), p = 0.01] and hospital visits [MD = 0.14, 95% CI (0.06, 0.22), p = 0.0006]. According to our subgroup analysis, either tadalafil 5 mg or 10 mg did not promote expulsion rate and accelerate expulsion time compared with tamsulosin. But patients receiving 5 mg tadalafil decreased analgesia usage [MD = 101.04, 95% CI (67.56, 134.01), p < 0.00001].

Conclusion: Compared with tamsulosin, tadalafil demonstrates a higher expulsion rate and less expulsion time for patients with distal ureteral stones less than 10 mm with a favorable safety profile.

Keywords: distal ureteral calculi; meta-analysis; prospective randomized trials; tadalafil; tamsulosin.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Forest plots showing the result between tadalafil and tamsulosin in (A) expulsion rate, (B) expulsion time. M–H, Mantel–Haenszel; CI, confidence interval; df, degrees of freedom.
FIGURE 2
FIGURE 2
Forest plots showing the result between tadalafil and tamsulosin in (A) need for analgesia, (B) pain episodes and (C) hospital visit. M–H, Mantel–Haenszel; CI, confidence interval; df, degrees of freedom.
FIGURE 3
FIGURE 3
Forest plots showing the result between tadalafil 5 mg and tamsulosin in (A) expulsion rate, (B) expulsion time and (C) need for analgesia. M–H, Mantel–Haenszel; CI, confidence interval; df, degrees of freedom.
FIGURE 4
FIGURE 4
Forest plots showing the result between tadalafil 10 mg and tamsulosin in (A) expulsion rate, (B) expulsion time. M–H, Mantel–Haenszel; CI, confidence interval; df, degrees of freedom.
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