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1 Asst. Professor, 2 Professor, 3 Junior Resident Department of Urology, VSS Institute of Medical Science and Research, Burla, Odisha *Corresponding Author Prof Dr. B.M Mishra Department of Surgery, VIMSAR, Burla, Odisha, India Mob no: 9437050270, Email: drbmmishra@gmail.com Abstract Background and Aims: Tamsulosin has been used widely for smaller (< 10mm) Ureteric stone in our practice and found to be efficacious. On the other hand the use of Tadalafil in medical expulsive therapy for ureteric stone is very limited .Therefore, we conducted a study to evaluate the efficacy and safety of Tadalafil in comparison with Tamsulosin for ureteric stone after one session of extracorporeal shock wave lithotripsy. Materials and Methods: This prospective randomized study was conducted at the Department of Urology of VSS Institute of Medical science and Research, Burla over a period of 18months in patients with ureteric stones of size 5 to 15 mm after one session of extracorporeal shock wave lithotripsy. Patients were divided into 2 groups by lottery method: Group A received Tadalafil 10mg and Group B received tamsulosin 0.4 mg at bedtime for 4 weeks. Stone expulsion rate, number of uretericcolic episodes and pain score, analgesic requirements, and adverse drug effects were noted in both groups. Statistical analysis were performed by using Student t-test and chi-square test. Result: A statistically significant expulsion rate of 73.8% in Group A compared with 85.3% in Group B (P value = 0.0120), and shorter stone expulsion time in Group B (14.2±3.4) in comparison to Group A (15.6 ±3.8) was observed. Although the adverse effects were more in case of Tadalafil, dose of analgesic requirements was lower and patient having erectile dysfunction were significantly benefited by using this drug.No serious adverse effects were noted in both group. Conclusions: This study showed that Tamsulosin is having better expulsion rate with shorter expulsion time than Tadalafil. Both drugs are safe and well tolerated. Patients having erectile dysfunction are significantly benefited by Tadalafil but it’s efficacy is lower than Tamsulosin.

Tadalafil versus Tamsulosin: As an Expulsive Therapy for Ureteric Calculus after Extracorporeal Shock Wave Lithotripsy