Comparison of Silodosin and Tamsulosin in Medical Expulsive Therapy of Distal Ureteric Calculi

Abdul Jabbar Arif; Muhammad Rafiq Zafar; Ammara Arif; Muhammad Sarwar Alvi; Adnan Ali; Anwaar Ahmad

doi:10.51253/pafmj.v76i5.10114

Authors

Abdul Jabbar Arif Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Rafiq Zafar Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Ammara Arif Department of Rehab Medicine, Armed Forces Institute of Rehabilitation Medicine/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Sarwar Alvi Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Adnan Ali Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Anwaar Ahmad Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i5.10114

Keywords:

Silodosin, Tamsulosin, Ureterolithiasis

Abstract

Objective: To carry out comparative analysis of Silodosin and Tamsulosin in medical expulsive therapy of distal ureteric calculi, in terms of stone clearance rate and stone expulsion time.

Study Design: Randomized clinical trial (clinicaltrials.gov - NCT05790902).

Place and Duration of Study: Urology OPD, Armed Forces Institute of Urology, Rawalpindi Pakistan, from Sep 2022 to Feb 2023.

Methodology: A total of 142 cases with unilateral Distal Ureteric Calculi (DUC) of <8 mm in size were enrolled and allocated randomly into two groups, each having 71 cases. Patients of Group-A and Group-B used 8 mg of Silodosin and 0.4 mg of Tamsulosin daily respectively. They were followed weekly until stone passage/four weeks, to document Stone Clearance Rate (SCR), no of Ureteric Colic Episodes (UCE), Stone Expulsion Time (SET), Postural Hypotension (PH) and Abnormal Ejaculation (AE).

Results: Group-A had signiﬁcantly better SCR than Group-B (80.3% vs 54.9%) (p=0.001). The Group-A exhibited signiﬁcant advantages of shorter mean SET (13.0±2.07 vs 15.55±1.74) and fewer no of UCE (p<0.001). Two patients (2.8%) of Group-A had PH as compared to three (4.2%) of Group-B (p=0.649). AE was observed more in Group-A than Group-B (28.2% vs 25.4%) (p=0.705).

Conclusion: Silodosin surpasses Tamsulosin in MET of DUC, in terms of SCR, SET and UCE; however, it has more retrograde ejaculation.

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