Tadalafil versus tamsulosin for distal ureteric stone expulsion; a prospective randomized comparative study

Background Tamsulosin, an alpha-blocker in medical expulsive therapy, selectively relaxes ureteral smooth muscle, while Tadalafil, a PDE5-Is, is recommended for treating lower urinary tract symptoms.Methods This study compares the effectiveness of Tadalafil and Tamsulosin as medical expulsive therapy for distal ureteric stones at the Urology Department, Beni-Suef University Hospital, Egypt, using baseline demographics, preoperative data, intraoperative data, and outcome analysis.Results A randomized comparative study that is prospective and was from March 2019 to March 2021. Although 280 instances were eligible, 30 were eliminated & 250 were randomized, and only 164 patients completed the study. 83 patients were in the study Tadalafil group (Group A), 54 males (65.1%) & 29 (34.9%) and 81 patients were assigned to the Tamsulosin group (Group B), 47 males (58%) &34 females made up the Tadalafil group (Group A). The study was completed by 34 females (42%). Additionally, there was a significant difference in the meantime for stone expulsion between groups A (8.8 +/- 3.1 days) and B (10.8 +/- 3.4 days, (p = 0.001). With fewer episodes of colic, Group A needed less analgesia than Group B.Conclusions Tadalafil is a safer and more effective treatment for 5-9 mm lower ureteric end stones, offering a higher stone expulsion rate, earlier passage, lower analgesic requirements, and fewer colic episodes.