Premium
Tamsulosin versus tamsulosin plus tadalafil as medical expulsive therapy for lower ureteric stones: A randomized controlled trial
Author(s) -
Jayant Kumar,
Agrawal Rajendra,
Agrawal Swati
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12496
Subject(s) - tamsulosin , medicine , tadalafil , urology , adverse effect , analgesic , randomized controlled trial , erectile dysfunction , anesthesia , surgery , hyperplasia
Objectives To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil as medical expulsive therapy for lower ureteric stones. Methods Between J anuary 2013 and D ecember 2013, 244 patients presenting with distal ureteric stones (size 5–10 mm) were randomized equally to tamsulosin (group A) or tamsulosin plus tadalafil (group B). Therapy was given for a maximum of 4 weeks. Stone expulsion rate, time to stone expulsion, analgesic use, number of hospital visits for pain, follow up, endoscopic treatment and adverse effects of drugs were recorded. Statistical analyses were carried out using S tudent's t ‐test and the χ 2 ‐test. Results There was a statistically significant higher expulsion rate in group B compared with group A (83.6% vs 65.5%; P ‐value = 0.031) and a shorter time to expulsion (14.9 ± 4.4 days vs 16.7 ± 4.8 days; P ‐value = 0.003). Statistically significant differences were noted in terms of the number of hospital visits and analgesic requirement in favor of group B. There was no serious adverse event. An improvement in erectile function was noted in patients of group B compared with those of group A. Conclusions Medical expulsive therapy for distal ureteric stones using tamsulosin plus tadalafil is safe, effective and well tolerated. Furthermore, tadalafil provides the additional advantage of improving erectile dysfunction when this condition coexists with a lower ureteric stone.