EFFICACY OF TAMSULOSIN VERSUS SILODOSIN IN PATIENTS WITH LOWER URETERIC CALCULI

Abstract

Background: The condition of urolithiasis remains one of the most common disorders, showing an increasing worldwide patient count, which leads to both life-quality deterioration and healthcare expenses [1, 2]. No sufficient evidence exists regarding real-world outcomes of α-blockers used as medical expulsive therapy (MET) for treating distal ureteric stones less than or equal to 10 mm in size. A randomized controlled study evaluated the therapeutic performance and security of tamsulosin and silodosin medications used in patients who had lower ureteric calculi.

Methods: The randomization process of 108 adult participants aged 18 to 75 years underwent a 1:1 division at Liaquat University (May–Nov 2024) for 0.4 mg daily tamsulosin treatment or 8 mg daily silodosin administration lasting up to 14 days. The drug comparison studied stone removal rates together with the amount of time needed for stone passage as the main study end points. The study analyzed additional measures such as the usage of analgesics alongside adverse effects and necessity for support procedures. Imaging consisting of US KUB and additional CT when necessary verified successful stone movement. The research sample of 108 participants delivered 90% statistical power to identify a 20% difference between the expelled stone rates at α=0.05 [3]. 

Results: The patients under silodosin therapy experienced both faster median expulsion (10 [IQR 8–12] days) and higher expulsion rate (88.9%) when compared to tamsulosin patients (68.5%, p=0.008). Patients in the silodosin group took less diclofenac medication than those in the tamsulosin group, with mean intake being 140 ± 60 mg compared to 220 ± 110 mg (p=0.002). The proportions of adverse events matched between groups with no statistically significant difference (p=0.45). One auxiliary ureteroscopy group. 

Conclusion: Treatment with silodosin shows superior effectiveness compared to tamsulosin when used for distal ureteric stones of size ≤10 millimeters because it results in better expulsion rates along with accelerated stone movement and decreased need for pain medication while maintaining similar adverse event frequency. Silodosin represents the best choice as an α-blocker for medical expulsive therapy when applied to this clinical condition.