Efficacy of tamsulosin and silodosin as medical expulsive therapy in the management of distal ureteral stones: a randomized controlled study

Urolithiasis is a significant and worldwide health problem. Ureteral stones account for approximately 20% of urolithiasis cases. 70% of those cases are with location of stone in the distal 1/3 rd of ureter hence known as Distal Ureteral Stones (DUS) or Lower Ureteral Stones (LUS). Recently certain drugs have been used as supplement for observation in an effort to improve spontaneous stone expulsion. Tamsulosin and Silodosin are such selective alpha-blockers which act by relaxing the ureteral smooth muscles, richly innervated by alpha-adrenergic receptors. 1-4 Silodosin is a highly selective alpha 1A adrenoceptor blocker. Medical Expulsive Therapy (MET) is an excellent treatment modality in appropriately selected patients. Evidence suggests that MET can decrease colic events, narcotic usage and re-visits. MET also reduces unnecessary surgeries and associated risks thereby reducing cost of treatment. Despite the evidence, MET remains underutilized as a treatment modality. Factors influencing the spontaneous passage of ureteral stones are stone size, configuration, location, smooth muscle spasm, sub mucosal edema, and anatomy of lower ureter. We evaluated the efficacy of Tamsulosin and Silodosin as the medical treatment of symptomatic uncomplicated distal ABSTRACT