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Category: Volume 08 Issue 09 September 2020
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Title: Comparative Study between Tamsulosin and Silodosin as a Medical Expulsive Therapy for Lower Ureteral Stones

Authors: Dr Md. Shahidul Islam, Dr Md. Mostafiger Rahman, Dr Wahida Akhtar Chowdhury, Dr Md. Mahabubul Islam, Dr Mst. Rawshon Ara Begum

 DOI: https://dx.doi.org/10.18535/jmscr/v8i9.07

Abstract

Objectives: To compare the efficacy of tamsulosin and silodosin as medical expulsive therapy (MET) for lower ureteric stones.

Materials and Methods: A prospective randomized study was conducted at outpatient department of Urology, Rangpur Medical College Hospital, Rangpur, Bangladesh during January 2017 and May 2019. A total of 220 patients with single unilateral lower ureteric stones 10 mm or less were included in this study.Cases were selected by inclusion and exclusion criteria and randomly allocated in two groups. Tamsulosin group (110 patients) and silodosin group (110 patients) were given tamsulosin 0.4mg and silodosin 8 mg daily at bed time respectively. The patients were prescribed diclofenac (50 mg) on demand for pain relief and were followed-up on weekly for 4 weeks by X-ray and ultrasonography of kidney, ureter and urinary bladder region. The expulsion rate, expulsion time, and analgesic requirements were also recorded. Data were analyzed and compared by statistical tests.

Results: According to our results, no statistically significant difference was found in terms of age, gender and stone size distribution between two groups. The stone expulsion rate was significantly higher in the silodosin group compared with the tamsulosin group, at 85.46% and 70.91%, respectively (p = 0.009). The stone expulsion time was also significantly lower in silodosin against tamsulosin groups as it was 13.12 ± 5.65 days vs.16.6± 5.2 days  respectively (p = 0.0001). The variation between analgesic doses required by patients in both groups were found statistically not significant (p=0.158).Overall, adverse effects were similar in both groups.

Conclusions: Silodosin is more effective than tamsulosin as medical expulsive therapy for lower ureteric stones.

Keywords: Tamsulosin,Silodosin, Ureter, Stone.

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Corresponding Author

Dr Md. Shahidul Islam

Associate Professor, Department of Urology, Rangpur Medical College, Rangpur, Bangladesh