COMPARATIVE PROSPECTIVE STUDY OF TADALAFIL, SILODOSIN ALFUZOSIN AND TAMSULOSIN AS THE MEDICAL EXPULSIVE THERAPY IN LOWER URETERIC STONE OF SIZE UP TO 10 MM

DR SANJAY KALA; DR V K MISHRA; DR VINAY KUMAR; DR CHAYNIKA KALA; DR AMIT SINGH; DR SASHI PRABHA

Volume : IX, Issue : V, May - 2019

COMPARATIVE PROSPECTIVE STUDY OF TADALAFIL, SILODOSIN ALFUZOSIN AND TAMSULOSIN AS THE MEDICAL EXPULSIVE THERAPY IN LOWER URETERIC STONE OF SIZE UP TO 10 MM

Dr Sanjay Kala, Dr V K Mishra, Dr Vinay Kumar, Dr Chaynika Kala, Dr Amit Singh, Dr Sashi Prabha

Abstract :

Aim– To compare safety and efficacy of tadalafil, silodosin, tamsulosin and alfuzosin as medical expulsive therapy for distal ureteral stone of size up to 10 mm. Material and methods: Comparative prospective study conducted in department of surgery, L.L.R.H, Kanpur, for period of 24 months in patients with distal ureteral stones of size up to 10 mm. Patients were randomly divided into 4 groups: group A received tadalafil 10 mg and group B received silodosin 8 mg, group C received tamsulosin 0.4 mg and group D received alfuzosin 10 mg bed time for 4 weeks. Stone expulsion rate, pain relieved or not, analgesic requirements and side effects were noted in all four groups. Statistical analysis was performed using student t test and chi square test. Results: Total patients enrolled in the study initially was 218, but few were lost to follow up. Finally, altogether 200 patients, 50 in each group were analysed in the study. 58.3 % of patients belonged to age group 20 to 30 yr. Male to female ratio 3.61:1. Mean stone size was 5.65±2.13. Demographic profile and baseline investigation were comparable in all 4 groups. Stone expulsion rate was significantly higher in silodosin (within 1 week) followed by tadalafil, tamsulosin and alfuzosin (within 2). Although occurrence of side effect, headache, flu like symptoms and postural hypotension were non–significant. Silodosin was more acceptable in patients because of earlier pain relief among tadalafil, tamsulosin, alfuzosin despite of retrograde ejaculation in few young patients as side effects. Conclusion: Silodosin has significantly higher stone expulsion rate followed by tadalafil, tamsulosin and alfuzosin. All four drugs are safe, effective and well tolerated with minor side effects