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.
References
- Norlin A, Lindell B, Granberg PO, Lindvall N. Urolithiasis: a study of its frequency. Scand J UrolNephrol. 1976; 10: 150-153.
- Pearle MS, Lotan Y. Urinary lithiasis: etiology, epidemiology,and pathogenesis. In: Wein AJ, Kavoussi LR, Novick AC, PartiAW, Peters CA, editors. Campbell-Walsh urology. 10th ed.Philadelphia: Saunders Elsevier; 2012. p. 1257-86.
- Ahmed AF, Al-Sayed AY. Tamsulosin versus alfuzosin in thetreatment of patients with distal ureteral stones: prospective, randomized, comparative study. Korean J Urol 2010;51:193-7.
- Ueno A, Kawamura T, Ogawa A, Takayasu H. Relation of spontaneous passage of ureteral calculi to size. Urology 1977;10;544-6.
- Singh SK, Agarwal MM, Sharma S. Medical therapy for calculus disease. BJU Int 2011;107:356-68.
- Kumar S, Jayant K, Agrawal MM, Singh SK, Agrawal S, Parmar KM. Role of tamsulosin, tadalafil, and silodosin as the medical expulsive therapy in lower ureteric stone: a randomized trial (a pilot study). Urology.2015; 85: 59-63.
- Hollingsworth JM, Rogers MA, Kaufman SR, Bradford TJ, Saint S, Wei JT, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet 2006; 368:1171-9.
- Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE, et al. Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. The American Urological Association. J Urol 1997;158:1915-21.
- Arrabal-Martin, A. Fernandez-Rodriguez, M.A. Arrabal-Polo, M.J. Garcia-Ruiz, A. Zuluaga- Gomez. Extracorporal renal lithotripsy: evaluation of residual lithiasis treated with thiazides. Urology 2006; 68: 956 – 959.
- J. Sowter. Tolley DA The management of ureteric colic. CurrOpin Urol. 2006; 6: 71 – 76.
- Jayant K, Agrawal R, Agrawal S. Tamsulosin versus tamsulosin plus tadalafil as medical expulsive therapy for lower ureteric stones: a randomized controlled trial. Int J Urol 2014;21:1012-
- KC Bahadur H, Shrestha A, Acharya G, Bahadur R, Shah A, Shresta P. Tamsulosin versus tadalafil as medical expulsive therapy for distal ureteric stones: a prospective randomized controlled trial. IC Urol.2016;57;351-356
- Puvada S, Mylarappa P, Aggarwal K, Patil A, Joshi P, Desigowda R. Comparative efficacy of tadalafil versus tamsulosin as the medical expulsive therapy in lower ureteric stone: a prospective randomized trial. Cent European J Urol.2016;69:178-182.
- Singh SK, Pawar DS, Griwan M.S. Tamsulosin as an Expulsive Therapy for Lower Ureteric Calculus after Extra Corporeal Shock Wave Lithotripsy: A Randomized Controlled Study. Int J Nephrol Urol,2011;3(1):62-68.
Corresponding Author
Prof Dr. B.M Mishra
Department of Surgery, VIMSAR, Burla, Odisha, India
Mob no: 9437050270, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.