COMPARISON BTWEEN SILODOSIN AND TAMSULOSIN AS A MEDICL EXPULSIVE THEREPY FOR URETERIC STONES

Abstract

Urolithiasis is a multifactorial disease that is often experienced in daily urological practice. Urolithiasis has been detected in 12% of the global population Medical expulsive therapy using α-adrenoceptor antagonists (alpha-blockers) had emerged as an alternative strategy for the initial management of small distal ureteral stones. When calculi are small (≤10mm), located in the distal part of the ureter, and with no clinical evidence of infection and pain, conservative pharmacological expulsive therapy may be indicated to accelerate the spontaneous passage of ureter stones. The objective of the present study was to compare the efficacy and safety of silodosin (8mg) vs tamsulosin (0.4mg) as a MET in the management of DUS in term of stone clearance rate and stone expulsion time, and adverse effects. The present study was a prospective randomized study and it was conducted at Ain Shams university hospital from September 2015 to September 2016.

The study group included 90 patients of distal ureteral stone that were devided randomly into 3 main groups each group contain 30 patients:  Group A (n=30): Received silodosin 8mg once daily at night for 4 weeks.  Group B (n=30): Received tamsulosin. 4mg once daily at night for 4 weeks  Group c (n=30): Received Placebo medication once daily at night for 4 weeks. All patient was be subjected to full medical history and recieve prescribtion in the first visit that include silodosin or tamsulosin or non of them in addition to NSAID in addition to good hydration. All patients were monitored every week till either expulsion of the stone or Passing four weeks without passing the stone. Analgesics administered to patients in case of pain during renal colic will diclofenac sodium 100mg. Our present study explain that the stone clearance rate was significantly higher in silodosin group compared with tamsulosin and control groups and the rate of stone expulsion was significantly higher difference in silodosin group than tamsulosin group and than control group while rate of stone expulsion was not significantly in tamsulosin group and control group.