Login to Access Video or Poster Abstract: MP90-20
Sources of Funding: None

Introduction

In recent years, medical expulsive therapy has been questioned in the management of distal ureteric stones. Therefore, we conducted a prospective randomized study to evaluate the possible role of tadalafil individually and in comparison with proven tamsulosin as well as a placebo therapy in distal ureteric stone expulsion.

Methods

Between January 2015 and March 2016, 327 patients who presented with distal ureteric stones of size 5–10 mm were randomly divided into three groups: tadalafil (Group A), tamsulosin (Group B), and placebo (Group C). Therapy was given for a maximum of 4 weeks. Stone expulsion rate, time to stone expulsion, analgesic use, number of hospital visits for pain, follow-up, endoscopic treatment and adverse effects of drugs were noted.

Results

A statistically significant expulsion rate of 86.0% in Group A compared with 66.0% in Group B and 38.0% in Group C was observed. Also a shorter stone expulsion time in Group A (13.5 ± 2.5) in comparison to Group B (16.4 ± 3.5) and Group C (24.8 ± 4.5) was observed. Statistically significant differences were noted in renal colic episodes and analgesic requirement in Group A in comparison to Group B and Group C. No serious adverse effects were noted.

Conclusions

Tadalafil is safe, efficacious, and well tolerated as medical expulsive therapy for distal ureteric stones. This study showed that tadalafil increases ureteric stone expulsion quite significantly along with better control of pain and significantly lower analgesic requirement.

Funding

None