Comparative Efficacy of Tamsulosin Versus Tamsulosin With Tadalafil in Combination With Prednisolone for the Medical Expulsive Therapy of Lower Ureteric Stones: A Randomized Trial

다국어 초록 (Multilingual Abstract)

Purpose: To compare the safety and efficacy of tamsulosin and tamsulosin with thephosphodiesterase-5 inhibitor tadalafil in combination with prednisolone as medicalexpulsive therapies for lower ureteric stones.
Materials and Methods: Between July 2011 and December 2012, 62 adult patients presentingwith distal ureteric stones sized 5 to 10 mm were randomized equally to treatmentwith tamsulosin (group A) or tamsulosin with tadalafil (group B). Therapy wasgiven for a maximum of 6 weeks. In addition, patients in groups A and B were given5-mg prednisolone once daily (maximum 1 week). The stone expulsion rate, time tostone expulsion, analgesic use, number of hospital visits for pain, follow-up and endoscopictreatment, and adverse effects of the drugs were noted. Statistical analyses weredone by using Student t-test and chi-square test.
Results: There was a higher expulsion rate (83.9% in group B and 74.2% in group A)and a lower time to expulsion in both treatment groups than in historical controls usedin earlier studies. However, these results were not statistically significant (p=0.349,p=0.074, respectively). Statistically significant differences were noted in hospitalizationfor colic and analgesic requirement, which were less in group B than in groupA. There were no serious adverse events. Another important finding was improvementin erectile function in group B.
Conclusions: Medical expulsive therapy for distal ureteric stones using tamsulosin andtadalafil with prednisolone is safe and efficacious. Also, the prescription of tadalafilin cases of erectile dysfunction with the development of lower ureteric stones may provideadditional advantages.

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