Title: Comparison of the Efficacy of Silodosin vs Tamsulosin, as a Medical Expulsive Therapy, in the Management of Distal Ureteric Calculus in Terms of Stone Clearance Rate
Authors: Nipun Bansal, Manjunath Shetty, Anuj Mahajan
DOI: https://dx.doi.org/10.18535/jmscr/v10i11.16
Abstract
Objective: To compare the efficacy of Silodosin and Tamsulosin as a medical expulsive therapy given for the conservative management of distal ureteric calculus in terms of Stone Clearance Rate.
Patient and Methods: A Prospective Observational Analytical Study was conducted on 120 cases between 18 years and 75 years with Unilateral distal ureteral single calculus (Distal to Iliac vessel crossing) and size less than or equal to 1 cm. The cases of this study were divided into two groups: Group A receiving Silodosin 8 mg tablet once daily and Group B receiving Tamsulosin 0.4mg capsule once daily. These patients were investigated with Serum Creatinine, X-ray KUB and USG KUB during the initial diagnosis. Each group received treatment for a period maximally 1 month. During this period the patient were evaluated for passage of calculus 2 weekly by Clinical history and by USG & NCCT (only incase USG was inconclusive).
Results: There was a significantly higher stone clearance rate of 81.67% in Group A vs 63.33% in Group B. Group A also showed a significant advantage for stone expulsion time.
Conclusions: Our data showed that silodosin is more effective than tamsulosin in the management of lower ureteric calculus for stone clearance rates and stone expulsion times.
Keywords: Silodosin; tamsulosin; distal ureteric stones, stone clearance.
References
- Erturhan S, Erbagci A, Yagci F, Celik M, Solakhan M, Sarica K. Comparative evaluation of efficacy of use of tamsulosin and/or tolterodine for medical treatment of distal ureteral stones. Urology 2007;69:633–6.
- Kumar S, Jayant K, Agrawal MM, et al. Role of tamsulosin, tadalafil and silodosin as the medical expulsive therapy in lower ureteric stone: A randomized trial (a Pilot Study). Urology. 2015; 85(1):59-63.
- 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.
- Cervenakov I, Fillo J, Mardiak J, Kopecny M, Smirala J, Lepies P. Speedy elimination of ureterolithiasis in lower part of ureters with the alpha1-blocker-Tamsulosin. Int Urol Nephrol 2002;34:25–9.
- Dellabella M, Milanese G and Muzzonigro G. Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. J Urol. 2005;174(1):167- 172.
- Küpeli B, Irkilata L, Gürocak S, et al. Does tamsulosin enhance lower ureteral stone clearance with or without shock wave lithotripsy? Urology. 2004;64(6): 1111-5.
- Karabacak OR, Yilmazer D, Ozturk U, et al. The presence and distribution of alpha adrenergic receptors in human renal pelvis and calyces. Urolithiasis. 2013;41(5):385- 388.
- Sasaki S, Tomiyama Y, Kobayashi S, Kojima Y, Kubota Y, Kohri K. Characterization of a1-adrenoceptor subtypes mediating contraction in human isolated ureters. Urology 2011;77, 762. e13-7
- Yilmaz E, Batislam E, Basar MM, et al. The comparison and efficacy of 3 different alpha1-adrenergic blockers for distal ureteral stones. J Urol. 2005;173(6):2010- 2012.
- Watts HF, Tekwani KL, Chan CW, et al. The effect of alpha-blockade in emergency department patients with ureterolithiasis. The Journal of Emergency Medicine. 2010; 38(3):368-73
- Tsuzaka Y, Matsushima H, Kaneko T, et al. Naftopidil vs silodosin in medical expulsive therapy for ureteral stones: a randomized controlled study in Japanese male patients. Int J Urol. 2011;18(11):792- 795
- El Sharaby et al. A Prospective Randomized Comparative Study between the Effect of Silodosin and Tamsulosin on Expulsion of Lower Third Ureteric Stones. AJRRU. 2021; 4(1): 20-29.
- Dell Atti L. Silodosin versus tamsulosin as medical expulsive therapy for distal ureteral stones: A prospective randomized study. Urologia. 2015;82(1):54-57.
- Rossi M and Roumeguere T. Silodosin in the treatment of benign prostatic hyper plasia. Drug Des DevelTher. 2010;4:291– 297.
- Elgalaly H, Sakr A, Fawzi A, et al. Silodosin vs tamsulosin in the manage ment of distal ureteric stones: A pros pective randomised study. Arab J Urol. 2016;14(1):12-7.
- Hollingsworth JM, Rogers MA, Kaufman SR, Bradford TJ, Saint JT, Wei JT, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet 2006; 368:1171–9.
- Parsons JK, Hergan LA, Sakamoto K, Lakin C. Efficacy of alpha-blockers for the treatment of ureteral stones. J Urol 2007;177:983–7.