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Randomized Controlled Trial
. 2025 Jun;57(6):1827-1833.
doi: 10.1007/s11255-024-04356-3. Epub 2025 Jan 10.

Comparative study between silodosin, tamsulosin, silodosin plus tadalafil, and tamsulosin plus tadalafil as a medical expulsive therapy for lower ureteral stones: a prospective randomized trial

Mohamed Mahmoud Dogha  1 , Ismail Gamal A Sherif  2 , Yasmin M Madney  2 , Hadeer S Harb  2 , Hoda Rabea  2
Affiliations
Randomized Controlled Trial

Comparative study between silodosin, tamsulosin, silodosin plus tadalafil, and tamsulosin plus tadalafil as a medical expulsive therapy for lower ureteral stones: a prospective randomized trial

Mohamed Mahmoud Dogha et al. Int Urol Nephrol. 2025 Jun.

Abstract

Purpose: To examine the safety and efficiency of a single-drug therapy with silodosin or tamsulosin versus combined therapy with silodosin plus tadalafil and tamsulosin plus tadalafil as a medical expulsive therapy (MET) for lower ureteral stones.

Methods: This research was a prospective randomized clinical trial carried out at Fayoum University Hospital, Egypt, over one year. Patients with lower ureteral stones (5-10 mm) were randomly allocated into one of four treatment groups. Group A received silodosin 8 mg per day; Group B received tamsulosin 0.4 mg per day; Group C received silodosin 8 mg plus tadalafil 5 mg daily, and Group D received tamsulosin 0.4 mg plus tadalafil 5 mg daily. Treatment was prescribed for up to 4 weeks. The study outcomes were the stone expulsion rate, stone expulsion time, the amount of analgesics used, the frequency of pain episodes, hospital visits, and any treatment-related adverse effects.

Results: One hundred eighty patients who fulfilled the inclusion criteria completed the study. Group C had a significantly elevated stone expulsion rate (91.1%) compared to Group A (57.8%) and Group B (71.1%) [P = 0.015, P < 0.001, respectively]. Group D had a significantly elevated stone expulsion rate (86.7%) compared to Group B (57.8%) [P = 0.002] and higher than Group A (71.1%). Group C and Group D had significantly less stone expulsion time, analgesic needs, and episodes of renal colic, and fewer hospital visits than Group A and Group B. No significant differences were found in adverse effects like orthostatic hypotension, dizziness, backache, headache, myalgia, and nausea between the patient groups.

Conclusion: Combining silodosin with tadalafil and tamsulosin with tadalafil was more efficient as MET for lower ureteric stones than a single treatment with silodosin or tamsulosin.

Keywords: Lower ureteral stones; MET; Silodosin; Tadalafil; Tamsulosin.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

References

    1. Jayant K, Agrawal R, Agrawal S (2014) Tamsulosin versus tamsulosin plus tadalafil as medical expulsive therapy for lower ureteric stones: a randomized controlled trial. Int J Urol 21(10):1012–1015 - DOI - PubMed
    1. Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y (2017) Epidemiology of stone disease across the world. World J Urol 35:1301–1320 - DOI - PubMed
    1. El Hadj Sidi AM, Diab T, El-Shazly AM, El-Dakhakhni AS, Abdel-Azim AF (2023) Efficacy of Silodosin versus Sildosin plus Tadalafil as medical expulsive therapy for lower ureteric stones: a prospective randomized placebo controlled study. Benha Med J 40(1):254–263
    1. Hsu Y-P, Hsu C-W, Bai C-H, Cheng S-W, Chen K-C, Chen C (2018) Silodosin versus tamsulosin for medical expulsive treatment of ureteral stones: a systematic review and meta-analysis. PLoS ONE 13(8):e0203035 - DOI - PubMed - PMC
    1. Sathish V, Achar U, Raj KC, Pai N (2022) An update on efficacy and safety of alpha-blockers in the treatment of distal ureteric stones: narrative review. Afr J Urol 28(1):1–12

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